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V 







THE 

NEW JERSEY 



MEDICAL REPORTER, 



AND 



TRANSACTIONS 



OF THE 



NEW JERSEY MEDICAL SOCIETY, 

EDITED BY 

JOSEPH PARRISH, M. D. 



VOL. HI. 



BURLINGTON: 
PUBLISHED BY S. C. ATKINSON. 

1850. 



INDEX. 

Page. 
A. 

Abscess, Milk ----- 1 

Appointments, Medical and Editorial Changes, - - 23 

Address, by O. H. Taylor, M. D., - - - 81 

Address, by Thomas J. Saunders, M. D., - - - 114 

Address, by Joseph Parrish, M. D., - - - 121 

Adjuster, Jarvis' - - - - - 170 
American Medical Association, 

Transactions of for 1847, - 189 

Minutes of for 1850, - 311 

B. 

Back, Point of a Sheath-knife in the - - 75 

Benevolent Fund, Report of Committee on - 100 

Biographical Notice of George McClellan, M. D., - 142 

Memoirof Dr. Moses Bloomfield, - - 161 

Benevolent Fund, ----- 207 

C. 

Convulsions, Puerperal two cases of - 7 

Children, Diseases of Practical Treatise on 18 

Cholera, its course and ravages, - - 39 

Chlorosis, Sulphate of Iron in ... 68 

Cholera in Paterson, Notes on the - - 166 

Conjunctivits, Strumous, Cod Liver Oil in - - 184 

College of Physicians, of Philadelphia, Transactions of - 199 

Collodion, and Collodium, Cantharidal - - 205 

Collodion, in Skin Diseases - 209 

Cholera, mucus membrane in, Report on - - 216 
Croup, use of Iodine in ----- 218 

Cotton, Gun Solution of in Erysipelas, - - - 219 
Cod Liver Oil, Modus Operandi of, ... 220 

Chloroform, in Collapse of Cholera, - - - 235 

Cholera, in a new born child, - 240 

" and Homoeopathy, - 240 
Clinical Records, ----- 308 

Correspondents, To, - 309 

College, New Medical, - - - - 309 



U INDEX. 

Page. 

D. 

Drugs, Adulterated and Spurious, Report on 15 

Drugs and Medicines, Adulterated, - - 20 

Dysmenorrhea, Lemon Juice in - - 78 

Dyspepsia, Pathology and Treatment of - - - 176 

Dysentery, Treatment of - - - - 226 

Delegates to American Medical Association, - - 302 

E. 

(Esophagus, Stricture of the, - 42 

Extracts, Medicinal, Tilden and Co., ... 206 

Education, Preliminary, Report on, - - - 278 

F. 

Fever, Typhoid, Observations on Epidemic, - - 229 

G. 

Gall Bladder, Absence of. (Autopsy,) - - 303 

H. 

Hymen, Vascular Excrescence on the, - 5 

Hiccough, Chronic, cured by Strychnine, - 43 
Harrison, The late Professor, .... 148 

Hospital, Pennsylvania, Report of the - - 198 

Hemorrhoidal Tumors, Case of, - - 212 

Hysterical fits, Moral Treatment of, - - - 228 

Homoeopathy, and the Cholera, - 240 

L. 

Lecture, Introductory, Dr. Eve's - - - 136 

Lead poison, Remarks on, - - - 154 

Labia, Venous extravasation of, - - - 174 

Lancet, Western, and Gazette of Legal Medicine, - - 208 

Licentiates, for 1850, - - - - 302 

M. 

Malignant Epidemic, an Account of a - - - 25 

46 
111 
157 
159 
203 
214 
223 
297 
309 



Malaria, On, ... 

Minutes of Semi-Annual Meeting, 1849, 

Muscular Contractions after Cholera, - 

Menstruation, Infantile, 

Medicine, Scientific, versus Quackery, 

Mania-a-potu, Treatment of - 

Male Children, Causes of greater mortality of, 

Minutes, Eighty-Fourth Annual Meeting, 1850, 

Medical Publications, New 



INDEX. 



N. 



Navy, United States, Medical Department of 
Neuralgia and Rheumatism, 



Obituary Record, 

Officers and Censors, 1850, 



O. 



P. 



Placenta, Manual Delivery of the - 
Puerperal Convulsions, Cases of 
Phthisis, Cod Liver Oil in, 
Physician and Patient, - 

Prison Reform Association of New Jersey, 
Pregnancy, Early, - 
Probe, St. Louis, - 

Pennsylvania, University of - 

Q- 

Quinine in Intermittens, etc., Modus operandi of 
Quinine and Opium, in Acute Rheumatism, 
Quackery, - - 

R. 

Report, University of Pennsylvania, for 1849, 
" on Adulterated Drugs, etc. - - 

" on Benevolent Fund, 

Resolutions, Dr. Stratton's 
" Dr. Taylor's, 

" Dr. Parrish's, 

" Dr. Lilly's " 

" Dr. Blauvelt's 

Report Annual, New Jersey Lunatic Asylum, 1849, 
" Pennsylvania Hospital, for Insane, 1849, 
" Committee on Cholera, in Philadelphia, - 

Rheumatism, Neuralgia and - 

Report, Standing Committee, 1850, 
" Salem County, (Dr. Gibbon,) 
" Dr. Elmer's 

" Gloucester County, (Dr. Garrison,) - 
" Essex and Passaic Counties, (Dr. Rodgers,) 
" Middle District, (Dr. Dunn,) 

" Standing Committee, Summary of, (Dr. Coleman,) 
" Preliminary Education, (Dr. Fithian,) 
" Charter and By-Laws, (Dr. Pennington,) - 



in 
Page. 

24 
227 

22 240 310 
301 302 

3 
7 

80 
138 
151 
159 
208 
310 

36 
181 
203 

13 
15 
100 
112 
112 
113 
113 
113 
185 
193 
216 
227 
241 
241 
246 
248 
258 
276 
278 
282 
291 



IV INDEX. 

Page. 

Resolutions, Dr. Taylor's, ... - 300 

Rare Case, ----- 306 

S. 

Standing Committee, Recommendation of the - - 114 

Sanitary condition of Philadelphia, Report on the - 139 

Splint ,Dr. Woolston's, - - - - 153 

Spleen, Rupture of the - - - - 156 

Scarlatina, Novel Treatment of - - - 238 

T. 

Tetanus, Peculiar case of - - - - 232 

U. 

University of Pennsylvania. - - - - 310 

V. 

Volume, our Third - - - - 19 309 



THE 

MW JERSEY MEDICAL REPORTER, 

VOL. III. TENTH MONTH, (OCTOBER,) 1849. No. 1 
ORIGINAL COMMUNICATIONS. 



MEDICAL MISCELLANY— By the Editor. 
MILK ABSCESS. 
There is no accident to which the parturient female is ex- 
posed, more dreaded by herself, than what she designates a 
"gathered breast;" and having been once afflicted with this 
kind of abscess, she anticipates its return, on every occasion 
of her lying in; hence it is of importance, as well for the suc- 
cess and reputation of the accoucheur, as for the comfort and 
well being of his patient, that such an occurrence should be 
averted, if possible. And as the testimony of all writers 
upon the subject is united in support of the opinion, that there 
is no phlegmonous inflammation, which takes on the suppu- 
rative process, with more certainty, or rapidity, than that 
which attacks the female mammae — to procure a resolution 
of the inflammatory action, is manifestly the first indication 
to be met, and the most desirable object to be gained ; but 
experience has proved how fruitless the most active mea- 
sures have been, may it not be said, in the majority of cases! 
Saline cathartics, local or general bleeding, as well as a va- 
riety of external applications, have been employed in the 
practice of the best and wisest men; but with what success, 
the painful history of the past, abundantly testifies. The 
late Dr. Dewees, whose reputation in this department of 



2 MILK ABSCESS. 

science, entitles his testimony to the highest regard, recom- 
mends bathing the breast with warm vinegar, as the most 
successful application in his hands; to be conjoined of course, 
with the usual constitutional remedies, for inviting the blood 
to other parts of the system, and reducing the local inflam- 
mation. It is true, that the failure to resolve the inflamma- 
tion may frequently be the result of carelessness on the part 
of the attendant, or of injudicious management in the early 
stage of the malady; but the "pertinacity of its course," to 
use the language of Dr. Dewees, is a peculiarity of mam- 
mary inflammation, which renders it capable of resisting in 
a great many cases the most active antiphlogistic treatment. 
During the first few j^ears of my practice, I had fre- 
quently to lament the ill success of remedies, which I had 
learned to estimate as powerful resolvents: and notwith- 
standing the most faithful perseverance in their application, 
I was frequently obliged to abandon them, and substitute 
supporting constitutional remedies, with such external means 
as were designed to aid the suppurative process. And it 
may not be considered presumptuous in me to say, that after 
repeated trials with a variety of unguents and liniments, I 
have abandoned them all, except the following, which I use 
in nearly every case of mammary abscess, and generally 
with entire satisfaction. 

R. Ung: Tabaci: oz. ii. 

Pulv: Camph: drchm ii. 

Ext: Belladon: drchm iss. ft: ung: 

The Belladonna is not always used, though I do not know 
that it is ever inadmissable. The tobacco ointment was first 
introduced to my notice by Wm. J. Allinson, an apothecary 
of this city, who makes it in a manner somewhat different 
from the officinal formula: vinegar or sour cider being used in 
the preparation, thus meeting in some measure the suggestion 
of Dr. Dewees. The tobacco ointment, itself, is a good appli- 
cation, but the addition of camphor, renders it more agreea- 
ble to the patient, counteracting in some measure the unplea- 



MANUAL DELIVERY OP THE PLACENTA. 3 

sant odor of the tobacco, and adding probably to its curative 
powers. It frequently affords relief even after the acute, 
lancinnating pain, and chill, which characterize the onset of 
the suppurative stage having been developed, and the tumor 
presents that glazed appearance which precedes the pointing 
of the abscess. I have a lady under treatment at this time, 
who has suffered from milk abscess after each of her confine- 
ments, (four in number,) so that the breast has become en- 
tirely useless to her ; not being aware of this fact when she 
came under my care a few weeks since, my attention was 
not particularly directed to the breasts, till on one of my 
visits, I found she had had a chill, followed by fever, and 
sharp, cutting pains in the left mamma ; the gland was 
much swelled, and just under the nipple was a shining pro- 
tuberance, indicating the locality for pointing. A muslin 
cloth the size of the gland, was spread with the ointment and 
the whole surface covered with it immediately, — the nipple 
presenting through an opening in the muslin. In about 
twenty-four hours, the application being frequently repeated, 
the pain and induration were partially relieved, and the pa- 
tient gradually recovered. Within the last two years I do 
not recollect to have seen a "gathered breast," though my 
opportunities for meeting with this form of disease have 
been four fold, in comparison with any former period — but I 
have frequently seen in that time the mammary gland 
swelled, painful, and threatening suppuration. Constitu- 
tional means are not of course omitted in cases where their 
usual signs are present. 



THE MANUAL DELIVERY OF THE PLACENTA. 

There appeared in one of the recent numbers of the Buffalo 
Medical Journal, some observations on the manual delivery 
of the placenta, exhibiting the practice of the distinguished 
editor of that periodical, in this respect, which were particu- 
larly gratifying to me, as a corroboration of the practice pur- 



4 MANUAL DELIVERY Off THE PLACENTA. 

sued by myself, and it is believed, by a number of others; 
though to deliver the secundines immediately after the ex- 
pulsion of the child, is not in conformity with the teachings 
of the schools. To wait twenty minutes, or half an hour? 
for the natural powers of the uterus to complete this last ef- 
fort of labor, is the generally adopted practice; it has so been 
taught by the most eminent men, and on that account is 
worthy of great respect, and ought not to be changed with- 
out sufficient evidence to warrant a different course. About 
one hundred and thirty obstetric cases have come under my 
care within the past year, and the practice has been adopted 
in each of them, without any untoward result being appa- 
rent. Immediately after the chord is separated, and the 
child removed, the left hand is applied over the fundus of 
the uterus externally, and pressure continued for several 
minutes, while slight traction is made upon the chord by the 
right hand. If by this manoeuvre, the attachments do not 
readily yield, the right hand is at once inserted into the va- 
gina, or uterus, as the case may require, and the edge of the 
placenta hooked by the index finger, or the whole viscus 
embraced* and dislodged from the uterus; at the same time 
the nurse is directed to make friction over the lower part of 
the abdomen. Is it not reasonable to conclude that alarm- 
ing uterine hemorrhage may be prevented by this practice, 
as the womb is made to contract speedily, and empty itself 
of its contents, by thus abruptly shutting up the mouths of 
the vessels which communicate between the maternal and 
foetal circulation? If the placenta is allowed to remain, se- 
parated as it generally is, from the fundus-uteri, and em- 
braced by the cerix, there is a space left in the cavity of the 
womb, which may be speedily filled with blood from the rup- 
tured vessels at the fundus, and the woman suffer exhaus- 
tion from loss of the vital fluid, while the accochoeur is pa- 
tiently waiting for the operation of nature. The fear of after 
pains is also materially lessened, as they mainly depend upon 



EXCRESCENCE ON THE HYMEN. 3 

the presence of coagulated blood in the uterus, which may 
be more readily and completely removed, by keeping up the 
tonic contractions of the womb until all its contents are eva- 
cuated. The child is expelled by a powerful muscular ef- 
fort; and when thrown out from the womb, the stimulus of 
its presence being removed, and the uterus not sufficiently 
contracted, it is necessary to supply an artificial stimulus by 
the hand externally, and if need be, by contact with the in- 
ternal surface, in order to complete the uterine action, and save 
the woman the suffering of after pains for several successive 
days, as well as relieve her from the risk of immediate he- 
morrhage. These suggestions are made after a fair trial of 
the practice, and are communicated to the profession for 
consideration. 

After the birth of the child, not more than five minutes 
need be allowed, in ordinary cases, for the completion of the 
whole process — the placenta being removed, and the uterus 
brought down into the pelvic basin, without the presence 
within its cavity of any offending body, to act as an irritant 
to its fibres, and cause the patient to surfer under their con- 
tinued contraction. 



VASCULAR EXCRESCENCE ON THE HYMEN. 

About a year since, I was consulted, by an anxious mo- 
ther, about her daughter, a tall, handsome girl of seventeen, 
who appeared to enjoy good health, but who complained 
frequently of great pain in passing her urine, and suffered 
considerable inconvenience from walking, owing, as the mo- 
ther thought, to a morbid growth, which, in her opinion, 
existed somewhere about the genitals; and which, so far as 
she could judge, protruded between the pudendi. This was 
the statement made to me, and, as I replied that nothing 
could be done without an examination, except by the em- 
ployment of emmolient and anodyne applications, I lost 
sight of the patient till about a month ago, when I was re- 



6 EXCRESCENCE ON THE HYMEN. 

quested to visit her. She was in bed, with headache, and 
fever, and complained of severe pain in the part alluded to. 
A saline cathartic was administered, and a warm flaxseed 
poultice, with camphor, applied, from the pubes to the os- 
coccygis. The bowels were freely evactuated in a few 
hours; the fever abated, and the next day she was prepared 
to submit to an examination. I expected to find an enlarge- 
ment of the clitoris, but on separating the labia?, this organ 
was seen to be no larger than usual, but a soft vascular ex- 
crescence presented itself upon the body of the hymen, about 
an inch below the orifice of the urethra. It was extremely- 
sensitive, and resembled somewhat, a small strawberry. The 
slightest touch was attended with extreme pain, and even 
the contact of the lubricated surface of the labise, except 
during perfect rest, in the horizontal posture, was the cause 
of constant complaint. The urine, coming in contact with 
it, in its passage from the urethra, created the extreme suf- 
fering which had been complained of during the progress of 
the case. 

The tumor was such as I had not seen before, — its loca- 
tion was certainly peculiar, and the treatment to be pursued, 
it seemed must be entirely experimental, as nothing that had 
come under my observation in the past could be referred to, as 
an example, to be governed by, now. To excise it, seemed 
dangerous, on account of its extreme vascularity. To pass 
a ligature around its base, and allow it to slough, would be 
an operation almost too painful to inflict upon a sensitive 
girl, if any other mode of curing could be adopted; and yet 
the disease was of too grave a character to allow of tempo- 
rizing treatment. These thoughts passed in my mind as I 
looked upon the trembling girl, fearing, as she did, some 
dreadful operation; and I determined to apply the solid ni- 
trate of silver. This I did immediately; and the application 
was followed by loud screams of anguish which continued 
for several minutes, but the pain soon subsided, and the 



PUERPERAL CONVULSIONS. 7 

nurse was directed to bathe the part with tepid water and 
laudanum, several times daily. Under the use of caustic, 
applied two or three times a week, perfect rest being en- 
joined, she has been enabled to resume her household duties, 
and is convalescing. 

Whether this is the same class of tumors described by 
Hossack and Mutter in papers published in the American 
Journal of Medical Science, I do not know. They are de- 
scribed under the name of "Irritable Tumor of the Urethra," 
and were found always in the urinary canal. They were 
considered as tumors mainly composed of erectile tissue, and 
were cured by excision. 



TWO CASES OF PUERPERAL CONVULSIONS. 
BY D. B. TRIMBLE, M. D. 

Case 1st — Was that of Mrs. W — , aged thirty, of good ge- 
neral health, sanguine temperament, cheerful disposition; 
but some hereditary predisposition to apoplexy. — This pa- 
tient had had four abortions between the third and fourth 
months of pregnancy, but had never had a child. I was 
called to see her on the 7th of May — then about seven months 
advanced in pregnancy, when I found her affected with se- 
vere head-ache, pains in the loins and abdomen; moderate- 
ly full, but frequent pulse ; flushed countenance; eyes turgid 
and staring, and constipation of the bowels. She had had 
an excellent appetite for the last month, and had grown ra- 
pidly corpulent. An examination per-vaginum showed the 
os-uteri to be undilated, and having had considerable diffi- 
culty in preventing abortion two months previously, I en- 
deavored to pursue a middle course, and therefore directed 
twenty leeches to be applied to the temples; a gentle aperi- 
ent, cold applications to the head ; rest, and light diet — 8th, 
better; the uterine contraction had ceased; pain in the head 
less severe; countenance less flushed; constipation relieved. 



8 PUERPERAL CONVULSIONS. 

In the evening, head-ache returned, countenance flushed and 
swollen. Attempted bleeding, but she became faint, and I 
desisted; applied sinapisms to the extremities, and continued 
the cold applications. 9th — saw her early in the morning — 
expecting to be absent until late in the day; prepared to 
bleed her again, when severe vomiting came on, and being 
hurried, ordered cups to be applied to the neck, and if this 
did not relieve, to send for a medical friend. About an 
hour after I left she was severely convulsed, and at the time 
bled largely. Vomiting continuing, she was directed to drink 
soda water. I saw her in the afternoon, when 1 found her 
quite delirious, countenance bloated; one eye apparently 
protruding, and blood shot; pulse soft, small and frequent ; 
continued the prescription. 10th — Mental perceptions rather 
clearer; vomiting continued; eye and countenance retained 
the same appearance. In the afternoon substituted for the 
soda water, Soda-Bicarb, gr. iii. 

Morph. Sulph, gr. |. 
Sig: take one every hour until relieved. After the second pow- 
der, she was not troubled with the vomiting. Applied blis- 
ters to the temples. 11th, Slept well; — pulse slower, fuller, 
and countenance more natural; mind calm, 'has felt no mo- 
tion of the child since the convulsion. She continued to im- 
prove, having no unpleasant symptoms up to the 29 th, 
when she left her chamber, and continued well, (with the 
exception of occasional slight pains in the hypogastric re- 
gion,) until the night of the 8th of June, when there was ac- 
tive contraction of the uterus, and the membranes were rup- 
tured. After this there was no more pain until the next 
night at 10 o'clock, when they "returned, and continued re- 
gularly, until 4§ o'clock, A. M., of the 10th, when she was 
delivered of a foetus in a state of partial decomposition. She 
is now as well as she could be in any confinement — not an 
unpleasant symptom supervening. (Oct. 1. — Has continued 
in good health, with one slight exception.) 



PUERPERAL CONVULSIONS. 9 

Case 2d — Mrs. W — , a lady of fine and active intellect, 
full, plethoric habit, short neck, strong circulation; twenty- 
seven years of age, and seven months advanced in her first 
pregnancy, sent for me on the 24th of May, on account of 
severe head-ache, accompanied with constipation. I took 
about fifteen ounces of blood from the arm, and directed her 
to take a purgative. This relieved her for three days, after 
which the pain returned, accompanied with somnium. She 
had been much agitated on hearing of the foregoing case, 
and told one of her friends she also expected to have con- 
vulsions* At 2 o'clock, A. M., of the 30th, I was again 
called to her; found that she had had two convulsions, and 
was then delirious. I attempted to bleed her, but her ex- 
treme agitation induced me to defer it; she Was soon after, 
affected with vomiting, which was succeeded by another 
convulsion of great severity. I then took sixteen or eighteen 
ounces of blood from her arm, with considerable reduction 
of the pulse, but she remained in a comatose state after the 
subsidence of the paroxysm. I prescribed Hydrarg: Chi: 
Mit: gr. x. to be followed by Magnes: Citras: f5 viii- — which 
produced copious dark alvine discharges; directed a large 
blister to the back of the neck, and sinapism to the extremi- 
ties. From seven to eight o'clock, A. M.; she had three 
more convulsions, equal to the former in violence; directed 
twenty-six leeches to be applied to the temples, her hair 
thinned, and ice applied to the cranium. Examined per vagi- 
num — and found the os-uteri rigid. She continued in this con- 
dition until 6 o'clock, P. M., when the convulsions returned, 
and she had three more of the same severity. I then re- 
quested that my experienced and talented friend Dr. Phillips, 
of Bristol should see her, and he arrived at 8 o'clock. We 
then bled her about twelve ounces, but without perceptible ad- 
vantage. Bowels still free. Had her head shaved; a large 
blister applied over the superior and anterior portions of the 
cranium, and ice to the remainder of the head. 31st, Morn- 
2 



10 PUERPERAL CONVULSIONS. 

mg— no amendment; os-tincse still undilated. Afternoon, 8 
o'clock, Dr. P. saw her again; we again bled her, and pre-* 
scribed Hydrarg: Pro: Chlr: in gr. ss. doses, every hour to 
produce ptyalism. At this time, I thought there was slight 
symptoms of labor, but being hurried, did not remain. At 
9 o'clock, P. M., her friends were very much alarmed, lest the 
convulsions should return, as she was very restless. I found 
she was in labor, and that the os-uteri was dilated one and a 
half or two inches. At 1 1 o'clock, P. M., she was delivered of 
a dead child, and remained quiet the rest of the night. At 5 
o'clock, A. M., on the 1st of June, consciousness began to 
return, and when I saw her at 7 o'clock, she knew me. Dr. 
P. saw her at 7§ o'clock, and our hopes were buoyant. We 
now omitted the calomel, continued the ice to the head, en- 
joined perfect quiet, light nourishment, &c. At 11 o'clock, 
A. M., our hopes were again depressed, as the convulsions 
returned with all their former intensity; she had three in 
quick succession. I saw her at 12 o'clock. She was again co- 
matose, I bled her again — about fifteen ounces. At 2 o'clock, 
P. M., consciousness had returned; recommenced the calo- 
mel at intervals of two hours; and sinapisms were again ap- 
plied. Her mind now seemed unclouded, though she com- 
plained of great pain and throbbing in the head, and pain in 
the abdomen. 2d, Symptoms improving; pain in the head 
unabated, but abdominal pain nearly relieved. Bowels open, 
3d, Continued to improve — though head-ache continues. — 
Slight ptyalism. Dr. Phillips discontinued his visits. 

4th, Pain in the head increased; more inclination to sleep, 
considerable pain in, and some tumefaction of abdomen; 
lochia suppressed. Applied twenty-four leeches to temples. 
Afternoon, gave 01: Ricini f$ i — sinapisms to feet. 5th, Pro- 
found sleep, great difficulty in arousing her; stertorous respira- 
tion; severe pain and soreness— and great enlargement of 
abdomen; pulse, moderately full, very frequent. Bled her, 
the fifth time— largely; administered an active dose of Mag- 



PUERPERAL CONVULSIONS. 11 

nes: Citras. Evening, symptoms slightly improved; applied 
blisters behind the ears, and above the ankles. 6th, Abdo- 
minal swelling subsiding; lochia somewhat increased; breasts 
swollen; somnolency, rather less; stertor continued. Pre- 
scribed Antim: et Potass: Tast: gr. ii. in Aqua f^ viii — a 
table-spoonful to be given every hour. Pulv: Digitalis: gr. 
iii. every two hours. Evening — milk fully secreted; abdo- 
minal swelling and tenderness subsiding; less inclination to 
sleep; considerable ptyalism. The stertorous respiration con- 
tinued up to the 9th, gradually abating — since when it has 
been very slight, and is now entirely relieved: — continued 
the last prescription until the evening of the 10th, when the 
Tart. Antim. was discontinued; and twenty-four hours after 
— (the pulse being soft and much slower) — the Digitalis also. 
All abdominal pain has ceased; pain in the head is slight, 
her mind is clear and cheerful, and she is decidedly conva* 
lescent. 

June 13th, 1849. 



Oct. 1st. In reviewing this case, I am led to believe from 
the continued insensibility, that considerable cerebral effu- 
sion must have taken place; and that her recovery from so 
severe and dangerous a condition of the system, was chiefly 
owing to the active depletion unloading the surcharged ves- 
sels, and that enabling them the more readily to re-absorb the 
effused fluid; and also to the effect of the mercury in in- 
creasing the activity of the absorbents. 

This patient continues in good health, but there is an in- 
creased excitability of the system, — and a slight cause would 
probably induce convulsions. 

Since the perparation of the notes of thesa two cases, I 
have had a third, which unfortunately, had not the success- 
ful termination of the first and second 1 cases. It was the 
case of a delicate woman — aged 26 — three months in her 
second pregnancy — and about ten days convalescent from 
an attack of dysentery — when she was attacked, whilst alone 



12 PUERPURAL CONVULSIONS. 

with a convulsion, and in the course of three weeks had 
nine — the last of which proved fatal. Dr. Phillips also saw 
this case with me, and the same course, (though not so ac- 
tively, owing to the delicate constitution of the patient) was 
pursued, as in case second. It differed from that case in there 
being entire sensibility after the subsidence of the paroxysm, 
and but little stertorous breathing. On the Saturday previ- 
ous to her death, she had three convulsions; one the next 
day, and no more until the following Thursday at half-past 
two o'clock, P. M. I did not see her until 4§ o'clock, when 
I found her with slow and labored respiration, but as strong 
and frequent a pulse as she had had for a week. It contin- 
ued to beat freely though slowly for some time after the last 
expiration— at 5 o'clock. 

This patient, as well as the second one, had convulsions 
in her infancy; and the family appear to be predisposed to 
this affection; as her mother informed me, that she had lost 
five out of her ten children with the same disease; one, a 
daughter of the same age, and under similar circumstances. 



BIBLIOGRAPHICAL NOTICES. 13 



BIBLIOGRAPHICAL NOTICES. 



Report of the Medical Department of the University of 
Pennsylvania, for the year 1849; — to the alumni of the 
School. By the Medical Faculty, Philadelphia. 

We cannot do justice to this Report by remarks of our 
own; and hence we copy the following extract from it, to 
enlighten our readers upon the success which has followed 
the reform policy adopted by the University, in conformity 
with the wishes of the American Medical Association. 

"The Faculty assure their friends that there has been no 
lowering of the grade of attainment required of the candi- 
dates; and they believe that, on no preceding occasion, has 
a class of graduates left the Institution better instructed in 
the elements of their profession than that of the present sea- 
son. Indeed, it is the impression of the Faculty that, owing 
to the considerable extension of the courses of instruction, 
they can perceive a greater general proficiency in the stu- 
dents than in former years. Upon the whole, therefore, 
whether in relation to the number of pupils, or to efficiency 
in imparting knowledge, the University has never been in a 
more prosperous condition than at this time. The Faculty 
have the more gratification in announcing this fact, as it 
proves that the policy which they adopted in the last two 
sessions, in accordance with the general sense of the profes- 
sion, as expressed by the National Medical Convention, and 
subsequently by the American Medical Association at two 
annual meetings, was a correct policy, so far at least as cor- 
rectness can be tested by success. It proves, too, that, in re- 
lying upon the profession in a course of proceeding, doubtful 
in its personal results to themselves, but clearly advanta- 
geous, in their honest opinion, to the general medical inte- 
rests of the country, they have not exhibited a false confi- 
dence, or rested upon a fallacious support. 

"In relation to the future, the Faculty would be true neither 
to themselves nor the profession, were they to draw back 
from the course of advancement upon which they have en- 



14 BIBLIOGRAPHICAL NOTICES. 

tered. At the last two sessions, the regular period of in- 
struction was five months and a half. At the next session, 
they propose to extend it to six months; the period which 
they deem most conducive to the true interest of the student, 
and which the American Medical Association has recognized 
as the standard to be aimed at by the schools. As three 
years of study, and attendance upon two courses of lectures 
in the schools are required of the candidates, it is thus seen 
that two-thirds of the whole term are to be devoted to pri- 
vate study, and only one-third to scholastic instruction. It 
appears to the Faculty that no one, familiar with the vast 
amount of various knowledge which it is now necessary 
to impart to the student, can consider the latter period 
disproportionately long. Either our forefathers must have 
erred greatly in exacting from the pupil an attendance for 
four months, when the number of branches separately 
taught, and the amount of instruction given were much less 
than at present, or we ourselves would assuredly be wrong in 
crowding the increased matter into the same space of time. 
The four months' system was adapted to an infant condition 
of the country, and a certainly much less mature state of 
the science than now exists; and to allow ourselves to be 
hampered by regulations suited to former times, would be 
to stand still while everything is advancing around us, and 
thus relatively to retrograde in the great march of human 
improvement. 

"Another point upon which the Faculty feel no little soli- 
citude is the due preliminary education of the student. The 
desirableness of such an education, as well as for the habit 
of study which it establishes as for the knowledge acquired, 
is denied by no one; and the only question is how far it can 
be demanded as an essential prerequisite to graduation. The 
Faculty do not despair of seeing the time arrive when this 
requisition may be made by the schools; but the object is 
one rather to be kept constantly in view, and to be attained 
gradually, than to be accomplished at once by a positive re- 
gulation. In this matter the profession must co-operate with 
the schools. There must be a general conviction in the me- 
dical community of the necessity of the measure; and the 
first barrier against the intrusion of ignorance into the pro- 
fession, must be at the door of the private office. When 
public professional opinion shall have become so enlightened 
and influential as to produce a general attention to this point, 
the schools may then step in, and make the requisition posi- 



SPURIOUS MEDICINES. 15 

tive and universal. In the meantime, they may aid materi- 
ally in the attainment of the end proposed, by lending their 
countenance to the principle involved on all suitable occa- 
sions; and the Faculty, in order to perform their own part, 
earnestly request that each pupil may bring with him a cer- 
tificate from his preceptor, stating the length of study and 
the possession of a due preliminary education when ascer- 
tained; so that such notice may hereafter be taken of the facts 
reported, as may seem most conducive to the desired object. 
: "In taking leave of their friends, the Faculty ask permission 
to join their congratulations with those of the enlightened 
members of the profession generally, upon the spread of a 
liberal and elevated public spirit among the great body of 
medical men, and the hope which it holds out of a steady 
advance in all that can adorn and dignify their calling, and 
increase its efficiency to the great ends for which it exists. 
''Philadelphia, July 12, 1849." 



Report on the Practical Operation of the Law delating 
to the Importation of Adulterated and Spurious Drugs, 
Medicines, fyc. By M. J. Bailey, M.D. Special Examiner 
of that class of Merchandise in the United States Cus- 
toms at the Port of New York. Read before the New 
York Academy of Medicine, June 6 th, 1849. 

This able document, published by the Academy of Medi- 
cine of New York, has reached us through several channels; 
and we take great pleasure in briefly noticing its contents, 
as the importance of the subject of which it treats, and the 
high authority from which it emanates, entitle it to the con- 
sideration of the profession. The law took effect in New 
York on the 12th of July, 1848, and the result of the inspec- 
tion which has been instituted, through M. J. Bailey, the 
Special Examiner, for that port, produces an aggregate of 
90,000 pounds of various drugs that have been rejected; and 
though the project met, in the beginning, with great opposi- 
tion from certain speculators in medicine, who depended 
upon the practice of adulteration for their daily bread, the 
developments exhibited by statistics, which are embodied in 
the Report, will fix the law, as we trust, beyond the reach 



16 BIBLIOGRAPHICAL NOTICES. 

of repeal, and be the means of executing justice upon those 
who have practiced, or who may hereafter practice, imposi- 
tion in the sale of medicines* In addition to adulteration 
which comes from abroad, the writer of the Report calls at- 
tention to the fact that there exists a domestic method of 
sophistication, which is not distinctly reached by the law re- 
lating to imported drugs. We copy the following extracts: 

"It will be seen that as far as sophisticated chemical and 
medicinal preparations are concerned, we have now but little 
to fear from the foreign manufacturer and speculator, while 
we have increased cause for unceasing vigilance at home, 
not only as respects the finer preparations, but also that al- 
most equally important class of medicines known to the trade 
as crude drugs, to wit : opium, barks, roots, medicinal gums, 
&c. &c. whether in a natural or powdered state; and while 
each and every article requires at all times the particular at- 
tention and scrutiny of the dispensing apothecary and phy- 
sician, I will here remark, that the article sold and pur- 
chased under the entirely too comprehensive name of Peru- 
vian bark, requires, in my opinion, much more attention, 
than it has heretofore received either from the apothecary 
or the profession. It will be seen by the statement submit- 
ted, that the quantity of spurious and worthless cinchona 
barks which I have thus far rejected, amounts altogether 
to some thirty-four thousand pounds ; and why have I 
rejected it ? Simply because the article containing none, or 
but a trace of the natural alkaloids of the true barks, and 
consequently possessing no febrifuge properties, is of no more 
value as a medicine than any other moderately bitter vege- 
table substance, while at the same time, it is not only un- 
safe, and improper, but on account of the large excess of 
woody fibre it contains, decidedly dangerous to be adminis- 
tered in cases where the genuine bark in substance is called 
for. 

"The several barks here alluded to, although differing in 
physical appearance, are those generally known in the trade 
as the red and yellow Maracaibo and Carthagena barks; and 
as they resemble the true officinal barks in color, they have 
long been used in a powdered state for the purpose of adul- 
terating those barks, or sold to the unsuspecting as the ge- 
nuine article. This fact shows very clearly why it has long 
been almost impossible to find on sale in the country, or 



SPURIOUS MEDICINES. 1 7 

even in any of our minor drug and apothecary establish- 
ments in town, one pound of the red or yellow cinchona 
bark of the requisite strength and purity; or, in other words, 
that will afford, on analysis, a per centage of alkaloids cor- 
responding with that produced by the genuine barks. Some 
samples that have been obtained afforded neither quinine 
nor cinchonine in any perceptible quantity! ! Others less 
than one fourth part of the alkaloids found in the true and 
pure barks; and so upward, according to the extent of the 
adulteration. From the quality of samples that have been 
forwarded to me from a distance, I am satisfied that the 
country is filled with such base mixtures and worthless trash; 
and it will take some time, with all the watchfulness that 
the profession can exercise, to get rid of the evil; an evil 
that must be deeply felt in those sections where the peculiar 
type of their fevers calls for an almost constant use of the 
cinchona in one form or another." 

To the deficiency of knowledge which exists among the 
profession in analytical chemistry, may be attributed a great 
deal of the oversight and negligence apparent with physi- 
cians and apothecaries, in regard to this subject, as it 
is certain that the practical benefits of the drug law must de- 
pend greatly upon the correctness of the analyses that are 
made, and that the soundness of the conclusions deduced from 
analytical investigation, must of course grow out of the mi- 
nuteness with which the science is studied. In conclusion 
we insert the following paragraphs, taken from the Report, 
on this subject. 

"As the progress of medical reform, with us, must hereafter 
be onward and upward, urged forward, as it is, by the most 
brilliant lights of the profession — men who are destined to 
occupy the highest niches in the temple of fame; it is to be 
hoped that our medical institutions will soon make such ad- 
dition to their requirements and means — notwithstanding it 
may subject the student to a somewhat greater expenditure 
of time and money — as will enable the professor of chemis- 
try, without pecuniary loss, to afford his class such extended 
and increased facilities as with proper attention will not only 
render them proficient in the science of analysis, but expert 
manipulators. Again, should each institution supply itself 
3 



18 BIBLIOGRAPHICAL NOTICES. 

with an extensive, conveniently arranged, and well selected 
cabinet of materia medica, for the use of the professor of 
that science, and to which he would direct the attention of 
his class, while it would enable him to lecture from samples 
of the substances either crude or prepared, as the case might 
be — immense benefit would, in my opinion, result therefrom. 
"I cannot, myself, see any good reason why it is not as 
important that a medical student should before graduating 
become as familiar with the physical appearance, composi- 
tion, peculiar qualities and strength of each and every reme- 
dial agent, he must, of necessity, be called upon to prescribe, 
as it is for him to acquire that intimate knowledge of every- 
thing pertaining to osteology and myology, which is very pro- 
perly deemed indispensable." 



Ji Practical Treatise on the Diseases of Children. By J. 
Forsyth Meigs, M. D., Lecturer on the Diseases of 
Children in the Philadelphia Medical Association; Fel- 
low of the College of Physicians of Philadelphia. Phi- 
lada. Lindsay and Blakiston, 1848. 

This is one of a series of works, the aggregate of which, 
when complete, will constitute the "Medical Practitioners' 
and Students' Library;" and it is worthy of notice here, as a 
valuable addition to the medical literature of our country, that 
ought to be in the library of every physician. Dr. Meigs has 
aimed, with much care, to embody in his work the opinions 
of the most eminent men, both at home and abroad, 
"always, however, endeavoring to judge what came under 
bis notice by the knowledge derived from his personal expe- 
rience in private practice."* He has given to the profes- 
sion a careful classification of the diseases of childhood, ac- 
companied with the most approved methods of treatment. 

In saying this much, we have said all that is necessary, to 
favor the work. The neatness of its typographical execu- 
tion reflects much credit upon the enterprising publishers. 

* Preface. 



EDITORIAL. 19 

NEW JERSEY MEDICAL REPORTER. 

EDITORIAL. 



BURLINGTON, TENTH MONTH, (OCTOBER,) 1849. 



OUR THIRD VOLUME. 

Two entire years have now elapsed since the enterprise 
of establishing a Medical Journal for New Jersey was pro- 
jected; and though they have been distinguished by a full 
share of trial and embarrassment in conducting the work, 
the apathy of our medical friends in lending us aid, has not 
been sufficient to deter us from commencing our third vo- 
lume; and having commenced, we are bound to carry out 
the arrangements, and to perform the labor, necessary to 
complete it. With New York and Philadelphia on either 
side of us, — the two great cities of the Union, — and the two 
great emporiums of medical science, and medical literature, 
our chance of success appeared to be small ; but our reli- 
ance has been, and still is, on the fraternal relations which, 
the members of the profession in New Jersey hold to each 
other, and the desire which they have shown in all the past 
— and which they still manifest — to sustain our noble call- 
ing in its purity, and to foster and strengthen among our- 
selves, the bond of continual brotherhood. Nowhere in this 
country, have physicians been more united, and for a longer 
time, than in New Jersey, and nowhere is the profession 
more free from the sin of charlatanism. Maintaining these 
relations to each other, and standing in an organized capa- 
city before the people, bound to exhibit them, it seemed 
proper and right that we should sustain a journal that might 
be the means of making the experience of each other the 
common property of all, and of distributing the proceedings 
of our society, not only to all sections of our own State, but, 
through the medium of other journals, to different parts of 



£0 EDITORIAL. 

our common country. Scarcely a number of the Reporter 
has gone out that has not taken with it the contributions of 
our own physicians, which have found place in other medical 
periodicals, and have contributed their share toward the im- 
provement and advancement of medical science. We would 
have been glad had the editorial labor fallen into abler 
hands, but as no one came forward to assume the task, we 
were not willing to shrink from it, and have endeavored, in 
the midst of a laborious practice, to do our duty, to subscri- 
bers, to our friends, and to the profession. If we have failed, 
it has not been for want of effort. If we have not failed, 
and the Reporter has proved itself worthy of support, we 
ask our friends to contribute more freely to its pages, and 
aid us in the extension of its circulation. We have no pe- 
cuniary interest in it. We have not asked for, or received a 
single cent for the editorial services that we have rendered, 
but we hope that the publisher, who relies for his compen- 
sation, entirely upon the promptness of the subscribers in re- 
mitting the amount of subscription, may not have cause to 
complain of the backwardness of any. 



A CARD. 

ADULTERATED DRUGS AND MEDICINES. 

Among the many good things that have already resulted 
from the American Medical Association, the action of that 
body, with reference to the arrest and detention of spurious 
drugs and medicines in the several ports of entry into the 
United States, holds a conspicuous place; and the hearty re- 
sponse with which the House of Representatives met the me- 
morial of the Association, and sought measures to effect the 
object contemplated by the memorialists, is indicative of a 
determination on the part of our national authorities to carry 
out the wishes of the Association, which should forever be 
regarded as an act of wisdom in the regulation of our go- 
vernment, that will always shed a lustre on the annals 



EDITORIAL, 2i 

of her political history. But the effect of the bill, prohibit- 
ing the importation of spurious drugs, &c., although sensibly 
felt at the present time, is not sufficiently so, to warrant an 
estimate of the great benefit that is yet to be conferred upon 
society by its passage : and with a view to its more perfect 
administration, a resolution was adopted at the last meeting 
of the American Medical Association, ordering that a Com- 
mittee of two persons from each State and Territory should 
be appointed, "whose duty it shall be to note all the facts that 
come to their knowledge with regard to the adulteration, and 
sophistication of drugs, medicines, chemicals, &c, and to re- 
port them through the Chairman at the next annual meeting." 
In compliance with this resolution, a committee has been ap- 
pointed by the Chairman of the Association, for New Jersey, 
consisting of Drs. Lyndon A. Smith, of Newark and Joseph 
Farrish, of Burlington, who hereby call upon the physi- 
cians of New Jersey, in the name of the Association, 
to aid them in the object committed to their charge. — - 
All communications giving information on the subject, ad- 
dressed to either member of the committee, will be carefully 
registered, and the facts therein contained, embodied in their 
report. The importance of this subject, to the success of me- 
dical skill, and to the well being of the community, need not 
be commented upon. While it may be supposed that we in 
New Jersey have but few opportunities of detecting the 
adulterations and impositions of the wholesale dealer, coun- 
try practitioners and apothecaries who procure their supplies 
from the large cities, do possess the means of eliciting much 
of the information that is sought by the Committee, and it 
is hoped that they will take an active part in these investi- 
gations, and consider themselves bound to furnish the Com- 
mittee with such facts as may be developed by diligent re- 
search. Without their aid the Committee can do nothing. 

Lyndon A. Smith, Newark, > Committee 
Joseph Parrish, Burlington, > 



22 OBITUARY RECORD. 



' OBITUARY RECORD. 



Died, in Cincinnati, June, 22d, Wm. A. Dougherty, M. D* 
Dr. Dougherty was a graduate of the Medical College of 
Ohio, session of 1847-8. — In Cincinnati, July 16th, of Cho- 
lera, Wm. Mulford, M. D., aged 48. — In Cincinnati, July 
22d, of Cholera, A. J. Baker, M. D., aged 32. — In Cincinnati, 
July 23d, of Cholera, William O'Donnell, M. D.— At South- 
ampton, England, John Shadwell, M. D., lord of the Manor 
of Horsfleld, in his 90th year. — Daniel Arnoldi, M. D., Pre- 
sident of the College of Physicians and Surgeons of Lower 
Canada. — At Beauharnois, Canada, Robert Carriere, M. D., 
of Cholera. — At Fairfield, N. Y., Dr. Green, of Cholera.— At 
Sylvania, near Toledo, Ohio, Dr. Horace Green, an estima- 
ble physician, of Cholera. — At Philadelphia, Dr. Thomas 
Fitch, 75. — At Manchester, N. H., Dr. Thomas Brown, of 
Cholera. — In New York, Dr. Alexis Smith, of Cholera, 49. 
— At Beverly, N. J., Dr. J. B. Warriner, of Cholera. — In 
Parras, Mexico, Dr. James 0'Riley,of New Haven, Conn., of 
Cholera. — At Washington, D. C, Nicholas W. Worthington, 
M. D., 60. — Dr. John Gregory, of Drayton, Geo., by suicide 
— eating opium, 30. — On board the steamer Sarah Sands, 
four days out at sea, Dr. Fisher of N. Y., formerly owner 
and editor of the Albion newspaper. — At Queechy Village, 
Vermont, Theodore Dexter, M. D., of Boston, 58. He was 
on a tour for the restoration of his health. — At Salisbury, 
N. H., Dr. John Butterfield, Professor of the Practice of Me- 
dicine in the Starling Medical College, Columbus, Ohio, and 
editor of the Ohio Medical and Surgical Journal. — At Burnt 
Corn, Alabama, Dr. George A. Wattle, by suicide, a native 
f n. Y. — At Taunton, Mass., Dr. Alfred Williams, 87. — At 
South Britain, N. Y., Dr. Joseph Winterbottom, Physician 
of the Nursery Hospital, Randall's Island, 30. — At Jackson- 
ville, Geo., Dr. T. F. Moore — shot in an affray, by Dr. Hum- 
phrey. — At Vernon, Conn., D. Scottoway Hinckley, 78. — In 
New York, Dr. J. H. Houston, Reporter of the U. S. Senate, 
formerly editor of the New York Lancet. — At Venice, Dr. 
W. A. Sparks, U. S. Consul. — At Little Compton,R. I., Ho- 
ratio Palmer, M. D., 34. — In Paris, of Cholera, Mr. Bougery, 
well known for his researches on anatomy, and as the author 
of one of the most magnificent works on anatomy and sur- 
gery ever published. — At St. Andrews' Fifeshire, on the 30th 
of July, John Reid, M. D., Professor of Anatomy and Me- 



MEDICAL APPOINTMENTS AND EDITORIAL CHANGES. 23 

dicine in the University of St. Andrew's. — In England, Mr. 
Clift, F. R. S. Mr. Clift has been long and deservedly well 
known, both in this country and in England, as the Conser- 
vator of the Hunterian Museum of the College of Surgeons, 
London; a situation which he has held for nearly half a cen- 
tury. — At Cincinnati, Ohio, September 1st, Professor John 
P. Harrison, of Cholera. At Utica, N. Y., Dr. Amariah 
Brigham, Superintendent of N. Y. Lunatic Asylum. 



MEDICAL APPOINTMENTS AND EDITORIAL CHANGES. 

Professor Bartlett has been appointed to, and accepted, 
the chair of medicine in the Louisville Medical school, va- 
cated by the resignation of Prof. Drake. Prof. Drake, it is 
understood, will become a member of the Faculty of the 
Ohio medical school, Cincinnati. 

Dr. Hunt, of New Orleans, has been elected to fill the va- 
cancy in the medical department of the University of Lou- 
isiana, occasioned by the death of Dr 8 Harrison. Dr. Ben- 
jamin Silliman, jr., has been appointed to the chair of che- 
mistry in the University of Louisville, and Prof. Yandell, 
formerly the incumbent of that chair, transferred to the chair 
of Physiology and Pathological Anatomy. 

Dr. H. J. Bigelow, of Boston, has been elected to the chair 
of clinical surgery in the Medical Department of Harvard 
University; Prof. Geo. Hay ward having resigned. Dr. Bige- 
low is a son of Dr, Jacob Bigelow, Professor of materia me- 
dica in the same school. 

Dr F. Campbell Stewart, of the city of New York, has 
been appointed Physician of the Marine Hospital, N. Y. 

Dr. Thomas Spencer, late Professor of the Institutes and 
Practice of Medicine in Geneva Medical College, has been 
elected to the chair of Practice in the Rush Medical College, 
Chicago, Illinois, and has accepted the situation. — Buffalo 
Medical Journal. 



The New York Annalist has been discontinued, and its 
subscription list transferred to the New York Journal of Me- 
dicine. The late editor, Dr. N. S. Davis, has been appoint- 
ed Professor of Physiology and Pathology in Rush Medical 
College, Chicago. • 

Two additional chairs have been created in the Medical 
College of Ohio, viz. ; Physiology and General Pathology, by 



24 MEDICAL APPOINTMENTS AND EDITORIAL CHANGES. 

Dr. L. M.'Lawson, and Surgical Anatomy and Clinical Sur- 
gery, by Dr. I. T. Shotwell. Dr. Daniel Drake now occu- 
pies the chair of Special Pathology and Practice of Medicine, 
and Dr. G. Y. Bayless, that of Descriptive Anatomy. 

In the University of Louisville, Prof. Short has resigned 
the chair of Materia Mediea, and Dr. Lewis Rogers appoint- 
ed in his stead. 

Dr. A. H. Baker, of Cincinnati, has been appointed Pro- 
fessor of Surgery in Indiana Central Medical College. 

In Transylvania University, Prof. Annan, has been trans- 
ferred to the chair of Theory and Practice, and Prof. Wm. 
M. Boling, of Montgomery, Ala., appointed to that of Ob- 
stetrics, vacated by Prof. Annan. 

The New Orleans Medical and Surgical Journal comes to 
us in a new dress, and with the gratifying announcement, 
that the sixth volume is commenced under more encourag- 
ing auspices than at any time since the work was com- 
menced. We heartily congratulate our friends on their flat- 
tering prospects. — Medical Examiner. 

MEDICAL DEPARTMENT, U. S. NAVY. 

The following gentlemen having passed a satisfactory ex- 
amination at the recent meeting of the Board of Examiners 
in New York, have been appointed Assistant Surgeons in 
the Medical Department of the U. S. Army. 

Wm. H. Ballard, of Louisiana; George K. Wood, of New 
York. Report in person at Jefferson Barracks. 

Joseph P. Brown, of Michigan. Report in person at Fort 
Mackinac. 

Alexander B. Hasson, of Maryland. Report in person at 
Fort Leavenworth. 

Jonathan Letherman, of Pennsylvania. Report in person 
at Fort Monroe. 

William A. Hammond, of Pennsylvania. Report in per- 
son at Carlisle Barracks, for duty with troops under orders 
to Santa Fe. 

Francis Sorrell, of Georgia. Report in person at Fort 
Johnson, N. C. 

Edward W. Johns, of Maryland. Report in person at Fort 
Columbus. 

Wm. W. Anderson, of South Carolina. Report in person 
at Fort McHenry. — Medical Examiner. 



ECLECTIC DEPARTMENT. 25 



ECLECTIC DEPARTMENT. 



Jin Account of a Malignant Epidemic^ (Congestive Ty- 
phus,) which prevailed in the early part q/'1849, at and 
in the vicinity of Mecklenburg, By Nelson Nivison, 
M. D. 

I propose, in this article, to give a short account of a ma- 
lignant epidemic with which we have recently been visited. 
In doing this, I do not propose to give a description of a new 
disease ; I believe it has been frequently recognized, and 
sufficiently described by many of our best American writers. 
Yet it is sometimes interesting to the profession to know to 
what extent, the time, and in what particular locality a ma- 
lignant disease with which we are already acquainted, pre- 
vails; especially in view of the fact, that notwithstanding 
all that has been said and written upon this type of disease, 
there yet remains, owing to its having generally been con- 
fined to particular localities, a very considerable number of 
practitioners, who, if not entirely ignorant of its existence, 
possess but a very limited knowledge of its essential nature, 
its characteristic phenomena, and as a matter of course, of 
its appropriate remedial management. I confess that, al- 
though I had read copious extracts from Dr. Minor's Essay 
on " Typhus Synchopalis," " Spotted Fever," &c, and 
much of what has been said of " Cold Plague," u Typhoid 
Pneumonia," " Head Pleurisy," " Pernicious," " Conges- 
tive" or " Malignant Remittents," '-'Congestive Typhus" or 
" Typhoid Fever," and especially Dr. Dickson's account of 
an epidemic that prevailed in 1806, in Medfield in Massa- 
chusetts, whence it spread gradually, extending itself winter 
after winter throughout New-England, into Canada and the 
middle states, progressing from village to village, and from 
one portion of the country to another, till, in 1313, it reached 
Philadelphia." I could form no adequate idea of the rapid- 
ity and certainty with which it sometimes destroys its vic- 
tims, if not speedily arrested by the appropriate treatment. 
4 



&# NIVISON ON MALIGNANT EPIFEMICf. 

The disease in question commenced its ravages about the 
middle of February last, some ten or twelve miles north of 
this place, in the adjoining county of Seneca, and in a very 
few days from the same time, a number of cases occurred in 
this vicinity, and especially some five or six miles south of 
us, and within a week of its commencement, it had visited 
all the intermediate neighborhoods. It was confined within 
the limits of a section of country some fifteen or twenty 
miles long in a north and south direction, and from four to 
six miles wide. This region of country presents nothing re- 
markable in its topography. It is situated principally in the 
county of Tompkins in the midst of one of the finest agri- 
cultural districts in central New-York, about midway be- 
tween the heads of the Seneca and Cayuga Lakes. It is neither 
level or very uneven, If celebrated for any thing, it is for 
the richness and fertility of the soil and the general salubri- 
ty of its climate. The principal diseases which have pre- 
vailed within the last year, have been measles, whooping- 
cough, and general catarrhal affections, and during a por- 
tion of the year we had dysentery, bilious remittent, and in 
one or two localities, intermittent fever. I would likewise 
mention in this connexion, that during the month of March 
of the last year, there occurred in the immediate vicinity of 
this village, a limited number of cases of a disease resem- 
bling, in almost all respects, the one I am about to notice. 
In this instance, however, it seems to be strictly endemic, 
extending but a few miles from this place in any direction. 
The mortality that attended this limited number of cases 
was perhaps relatively greater than during its recent visita- 
tion. This may be owing in some measure, to the fact that 
physicians were less familiar with its phenomena, and con- 
sequently with its proper management. But I think it was 
mainly due to the fact of its having prevailed but a short 
time, attacking a limited number of persons, and those few 
in a fearfully malignant form. Whereas, in the latter case, 
it continued to prevail to a greater or less extent for about 
three months. During the first month it was sufficiently 
malignant, but in the two latter, it attacked a much larger 
number of persons, and generally in a much milder form ; 
during the last month of its prevalence it gradually became 
blended with other diseases, to which it imparted more or 
less of its peculiar characteristics, and finally disappeared 
altogether, so that towards the close, fatal cases rarely, if 
ever, occurred. 



NIVISON ON MALIGNANT EPIDEMIC, 27 

The disease commenced during the extreme cold weather 
of February, the mercury being from 12 to 20 degrees below 
zero. The persons most usually attacked were those in 
middle life and children, although no age seemed to be en- 
tirely exempt. It oftener attacked males than females. It 
would appear that a previous state of debility or indisposition 
had much to do in predisposing the system to an attack of 
this disease, and we think we are safe in assuming general- 
ly, whatever the essential cause of the disease may be, 
where it exists in a sufficiently active state to produce the 
disease at all, the exciting causes are those that tend tempo- 
rarily to debilitate the vital organs, and thus cause them to 
perform their functions imperfectly. Hence the fatigue that 
results from over-exertion, was often followed by an attack 
of the disease. Mental anxiety was another exciting cause. 
But it is believed that no single cause contributed so much 
to excite the disease in persons predisposed as the protracted 
influence of cold. Persons who were necessarily much ex- 
posed, and especially those in the lower walks of life, who 
had not the means of affording themselves adequate protec- 
tion from the severity of the season, were most frequently 
found among its victims. 

Another evidence that the influence of cold had much to 
do in the production of this disease, was the fact that during 
the whole time of its prevalence, simultaneously with, or 
immediately following, a change from a higher to a lower 
temperature, was the occurrence of a considerable number 
of new cases. 

The precise mode of invasion differed exceedingly in dif- 
ferent cases, the attack not unfrequently came on without 
any premonitory symptoms whatever; usually however, it 
gave indications of its approach by symptoms, in many re- 
spects resembling those that precede the ushering in of an 
attack of an ordinary remittent, superadded to which, there 
was generally a feeling of extreme anxiety, oppressed respi- 
ration, of great and often alarming prostration, giddiness, ex- 
treme dulness of the intellect, not unfrequently the first indi- 
cation of an attack was a severe pain in some part of the 
body, usually the extremities ; sometimes it was confined to 
a single joint of a finger or toe. Soon the surface became 
cold, the extremities livid, the blood often left the superficial 
vessels of the face, giving the countenance a sort of doughy 
paleness. In some cases, numerous petechial spots made 
their appearance upon the face, neck and surface of the 



28 NIVISON ON MALIGNANT EPIDEMIC. 

body. The conjunctiva was usually highly injected ; more 
or less pain was always complained of in the head, usually 
in the supraorbital regions; this was often very severe, and 
accompanied, as it often was, with great intolerance of light 
and sound, and delirium, which was frequently wild and fu- 
rious. It was often exceedingly difficult for the inexperi- 
enced practitioner to persuade himself that he had not met 
with a case of genuine phrenitis. Let him beware, howe- 
ver, of an error of this kind, for it would most assuredly be a 
fatal one. Violent clonic spasms were a frequent accompa- 
niment of this pain in the head ; often, however, the patient 
was comatose, and the symptoms approximated somewhat 
to those of apoplexy. 

The pulse was variable, but always weak, usually quite 
frequent, but sometimes remarkably slow, not being over 
forty in a minute. An intermitting pulse was often ob- 
served. 

The tongue at the commencement was frequently consi- 
derably swollen ; usually it was covered with a thin white 
fur, which became thicker and darker as the disease ad- 
vanced ; sometimes the tongue was clean and of a bright 
red color. Fainting, nausea, with occasional vomiting, was 
present; the ejections from the stomach being generally 
mixed with bile. 

From a careful attention to the order of development of 
the symptoms, it would appear that the brain and nervous 
system were generally the first to suffer, and that the dis- 
turbance of the circulating and respiratory systems, were 
measurably the results of this nervous derangement. Often, 
however, the functions of all the vital organs were so nearly 
simultaneously affected, that it was difficult, if not quite im- 
possible, to determine which was first in the order of se- 
quence. Nor was it very material, for in the severe cases, 
the "congestive" symptoms increased in intensity, from hour 
to hour, with such rapidity, that unless the morbid train of 
symptoms was speedily arrested by the appropriate remedial 
management, a fatal coma, with entire insensibility, loss of 
circulation and respiration, speedily came on, and death 
closed the scene, in from six to twelve hours from the com- 
mencement of the attack. These extreme cases, however, 
were rare. In a great majority of cases the symptoms were 
more slowly developed, and in those cases a fatal termina- 
tion in the early stages was by no means frequent. Usually, 
after the first shock given to the svstem had subsided, and 



NIVISON ON .MALIGNANT EPIDEMIC, 99 

reaction was established, a low grade of fever, characterized 
by more or less distinctly marked remissions, would follow 
for several days. This fever was always of a decidedly 
typhoid character. Active antiphlogistics were in no case 
tolerated. Sometimes prolonged and extremely exhausting 
cold sweats attended this stage of the disease. These were 
often extremely troublesome during sleep. If the patient 
was allowed to sleep a few minutes too long, the sweating 
was profuse, he was aroused with great difficulty, and awoke 
with a feeling of extreme exhaustion. 

In some cases there appeared to be no febrile reaction 
whatever; it was only by the aid of the most active stimu- 
lation, that the vital organs could be induced to perform 
their functions at all, and often then in the most sluggish 
manner. Some cases were noticed, laboring under a severe 
form of this disease, in which the nerves of general sensibi- 
lity were nearly paralyzed; for although the patients were 
hourly in danger of losing their lives, no pain or uneasiness 
was complained of; the pulse could not be raised above 
forty or forty-five, the respirations twelve to fourteen per 
minute. 

It may seem almost incredible, what enormously large 
doses of the most actively stimulating articles could be borne 
with impunity ; from 20 to 30 grains of the sulphate of qui- 
nine, with proportionately large doses of camphor, carbonate 
of ammonia, alcoholic stimulants, etc., were often given in 
the course of twenty-four hours. One patient, that ultimately 
recovered, was kept in this active course of stimulation for 
many days in succession, often taking a pint of brandy in 
from four to six hours without any inconvenience. These 
doses were not only tolerated, but imperiously demanded. 
With all this, the surface was uniformly cool, often cold, 
never warm, unless warmed by artificial heat. On several 
occasions in the patient above alluded to, stimulants taken 
into the stomach and applied to the surface, seemed to have 
exhausted all power ; the mucous surface of the stomach 
seemed to have lost its sensibility, and was no longer capa- 
ble of absorbing or acting upon its contents ; the most active 
stimulants produced no effect. The pulse rose rapidly from 
45 to 130, then became intermittent, and finally almost im- 
perceptible, the surface entirely cold. All that remained of 
respiration, was an occasional hurried, convulsive gasping 
or sighing. It really seemed that the patient must succumb, 
In this emergency, an enema composed of six ounces of 



30 NIVISON ON MALIGNANT EPIDEMIC. 

brandy, with a strong infusion of capsicum, was given, 
This was successful in rousing to action the small amount of 
vital force that yet remained. Under its influence the sto- 
mach was again excited to action ; its contents were thrown 
off by vomiting, which, by its revulsive effect, gave a new 
impetus to the nervous and circulating systems, under the 
influence of which the former sluggish action was restored, 
and things went on as before. A similar state of things oc- 
curred several times in the course of a protracted illness, 
during the whole period of which no local organic disease 
could be detected, and no febrile action established, the dis- 
ease seeming to be throughout its entire course of a purely 
adynamic character. This case, though no fever was pre- 
sent, was yet characterized by very distinct remissions. 
These remissions occurred in the morning, followed by ex- 
acerbations (not of fever,) but of prostration and debility, 
which followed the course of an ordinary exacerbation of 
fever; in that it commenced towards noon, increased till 
evening, was greatest near midnight, and declined towards 
morning. 

The prognosis in this disease depends mainly on the 
treatment. The prompt application of the proper remedial 
measures, was generally successful in arresting the disease 
and restoring the patient to health in from two to twelve 
days. Indeed, in most cases, even those of the gravest 
character, if a proper course of treatment be early resorted 
to, and energetically and perseveringly applied, little dan- 
ger of a fatal termination need be apprehended, so long as 
the disease remains uncomplicated. 

But it must be obvious to the pathologist, that so severe a 
shock as is given to the system during the cold, or conges- 
tive stage of the disease, cannot often be borne with entire 
impunity, and that the result must be a greater or less de- 
gree of organic mischief, and accordingly, we find cases 
protracted to an undue length by the occurrence of various 
secondary affections. The particular organ or organs thus 
secondarily affected, depends, of course, on the predisposi- 
tion of the system, the weaker parts, making the least resis- 
tance, are soonest overpowered. A temporary suspension 
of functions, followed by a greater or less degree of inflam- 
matory action, of a decidedly asthenic character, is the con- 
sequence. Thus, if the lungs be the weaker organ, we may 
have pneumonia ; if the bowels, enteritis, etc. Some wri- 
ters, apparently overlooking the primary affection altoge- 



NIVISON ON MALIGNANT EPIDEMIC. 01 

ther, have given various names to this peculiar form of dis- 
ease, which have reference only to some of these complica- 
tions. Hence we have " typhoid pneumonia," " head pleu- 
risy," and a host of other names of a kindred character. 
Even so slight a circumstance as the occasional appearance 
of petechial spots has been obliged to contribute to the no- 
menclature. Hence "spotted fever," notwithstanding the 
fact that five-sixths of all the cases have no "spots" at all. 
Any names of this kind, being derived from some fortuitous 
circumstance by no means essential to the disease, are deci- 
dedly objectional, and calculated to mislead; although it 
cannot be denied that these secondary affections, occurring 
in the debilitated and adynamic condition of the system pe- 
culiar to this disease, are often more troublesome than the 
original disease itself, and frequently call in requisition the 
most accurate discrimination, the most valuable resources, 
combined with that peculiar aptitude in their application 
which so readily distinguishes the truly scientific physician 
from the boasting quack or the mere routine practitioner. 

One peculiarity of this disease was the great tendency to 
relapses. Often after the patient was apparently out of all 
danger, from some slight cause, severe, and in some instan- 
ces, fatal relapses occurred. One of the most fruitful of 
these causes was a change from a higher to a lower tempe- 
rature. Several of these relapses would sometimes occur in 
the same patient. Fortunately, however, they were gene- 
rally less severe than in the first attack. 

This disease, like other epidemics, impressed more or less 
of its peculiar characteristics upon other diseases that were 
prevailing at the time of its occurrence, a decidedly typhoid 
tendency being present in almost all cases, and a correspond- 
ing modification in their treatment became necessary; even 
purely inflammatory diseases required a much less energetic 
antiphlogistic treatment than usual. 

A singular case of its alternative with parotitis, which was 
prevailing at the time, came under the observation of the 
writer, The material points of which were as follows : 

M. H., set. 20, occupation a painter, was attacked with 
the prevailing epidemic, Feb. 20th.; had been from home 
the day before; while absent, was taken with pain and 
swelling in the region of the parotids, and from the fact that 
mumps were prevailing in the family at the time, no doubt 
was entertained as to the nature of the local symptoms. 
When I visited him the next day, the region of both paro- 



32 NIVIS0N ON MALIGNANT EPIDEMIC. 

tids was much swollen. Early in the morning, symptoms 
of a violent attack of the prevailing epidemic set in ; the fa- 
mily, however, supposing that mumps was the only diffi- 
culty, were not immediately alarmed, and it was some four 
hours from the commencement of the attack before I saw 
him. I then found him with cold extremities, pulse scarcely 
perceptible, had complained of great pain in the head, eyes 
red, talking incoherently, the trunk and extremities thrown 
in almost every variety of position by violent spasms, the 
jaws much of the time spasmodically closed, had not swal- 
lowed for three hours ; some fluid was introduced into the 
month, and efforts were made to induce him to swallow it; 
as soon however, as it reached the glottis, the most violent 
spasms were induced, which lasted for some minutes, seve- 
ral of these attempts were made, and with the same result. 
Finding all attempts to introduce medicine into the stomach 
to be ineffectual, the congestive symptoms in the mean time 
increasing to an alarming extent, I determined for a time to 
abandon them, and rely upon external means. A large sina- 
pism was applied to the epigastrium, cloths wrung out of 
hot water applied to the throat, hot bricks, blocks of heated 
wood, and bottles of hot water, were placed near the patient, 
stimulating frictions were applied to the spine and extremi- 
ties, and finally, the symptoms becoming more and more 
alarming, a current of hot vapor was passed into the bed ; 
the spasms soon subsided, the pulse, which for a time could 
not be felt at the wrist, was again perceptible at intervals, a 
tolerably free perspiration came on, and the vapor was dis= 
Continued ; some stimulants were now swallowed ; the pa- 
tient continued to revive; in two hours would answer ques- 
tions ; complained of violent pain in the head ; occasional 
delirium ; would strike his head violently with his fist, tear 
out his hair, &c. Two grains of opium were now adminis- 
tered, which afforded great relief. The swelling about the 
throat subsided rapidly, and in twenty-four hours from the 
commencement of the attack it had entirely subsided. In- 
deed it disappeared so suddenly, that some doubt was enter- 
tained whether in reality he had mumps at all. The dis- 
ease was treated with opium, camphor, quinine, &c, and at 
the end of the first week had nearly subsided; about this 
time the swelling reappeared in one of the parotids, conti- 
nued about the usual time for mumps, and gradually subsi- 
ded ; about this time, and while the patient was yet in a de- 
bilitated condition, upon a sudden change of temperature, 



NIVIS0N ON MALIGNANT EPIDEMIC. 33 

he was seized with a relapse of the original disease, which 
was quite equal in severity to the first attack ; this was 
treated upon the same general plan as the first, with the like 
result, subsiding about a week from its commencement; 
about this time the swelling made its appearance in the pa- 
rotid of the opposite side, continued for three or four days, 
and disappeared. From the peculiar manner in which these 
several swellings disappeared and again re-appeared, through- 
out an interval of more than three weeks, some doubt was 
entertained in regard to its real nature ; and had it not been 
for the fact that about the time of the subsidence of the last 
swelling, it again made its appearance in one of the testi- 
cles, in the manner peculiar to this disease, doubts might 
still have remained whether mumps had any thing to do 
with it. 

Fn regard to the treatment of this disease, we think we are 
safe in affirming that almost every thing depends upon in- 
suring, at the earliest practicable moment, a reaction : this 
being once effectually secured, in a great majority of cases 
the after treatment is comparatively easy ; whereas, without 
it, it is believed that many otherwise simple cases would tend 
speedily to a fatal termination. I would by no means be 
understood to convey the impression that no danger need be 
apprehended after this reaction has been once secured. For 
if it be important in the first place to obtain it, it is equally 
important to maintain the favorable impression throughout 
the future progress of the disease. In a majority of cases 
this is not difficult. The well-timed use of the same class of 
remedies that were found successful in the first instance ill 
bringing on the reaction, was found sufficient to maintain 
it. This, however, was far from being universally the case. 
In many cases of the graver forms of the disease, a complete 
reaction was with difficulty secured at all, and if fortunately 
once obtained, the tendency to relapse into its former state 
was so great, that nothing short of the most energetic and 
assiduous application of the appropriate remedial measures^ 
for a considerable space of time, was sufficient to maintain 
the equilibrium of the nervous and circulating systems, and 
prevent the patient from sinking rapidly into a fatal stupor. 
Often, when all things were moving steadily in the right di- 
rection, a delay or neglect of the proper remedies for a few 
hours, through the indiscretion of incompetent nurses, was 
sufficient to place the patient entirely out of the reach of 
remedies. 
5 



34 NIVISON ON MALIGNANT EPIDEMIC, 

The particular remedies to be made use of in order to 
secure this impression, will probably vary somewhat, ac- 
cording to the prejudices, taste or predilections of the practi- 
tioner. It would hardly seem necessary, in speaking of the 
treatment of a disease so purely asthenic in its character, to 
make mention of blood-letting. Some practitioners, howev- 
er, disregarding entirely the ataxia spirituwri, and consi- 
dering the congestion of the internal organs as the only es- 
sential element in the disease, have sought to make the de- 
sired impression upon the system by directly diminishing the 
quantity of circulating fluid, supposing thus to relieve the 
congested organs, and invite the remaining portions of blood 
back to the periphery of the body. Perhaps the best com- 
mentary upon this is, that almost invariably, where it has 
been practised, a fatal termination of the case speedily fol- 
lowed ; and even in those very rare cases of a mild charac- 
ter, where recovery slowly followed venesection, it is confi- 
dently believed that the recovery would have been much 
more rapid without it. 

In general, those remedies that stimulated the surface and 
conveyed external warmth to the body, were found most 
useful in this stage of the disease. The application of a 
large mustard plaster to the epigastrium, highly stimulating 
frictions, bottles of hot water, hot bricks, flannel cloths mois- 
tened with hot spirits of turpentine, dry cups applied along 
the spine ; remedies of this kind, especially if encouraged by 
the free administration of warm diluents, and if necessary 
warm brandy and water, spirits of camphor, etc., rarely fails 
in a short time to produce a gentle perspiration, followed by 
a marked abatement of most of the symptoms. Often the 
free administration of warm drinks, in this stage, is followed 
by tolerably free vomiting, the revulsive effects of which aid 
materially in bringing on reaction. There are in these ef- 
forts frequently large quantities of bile ejected from the sto- 
mach. 

Some practitioners have hence spoken highly of emetics in 
this stage of the disease. In mild cases they are doubtless 
sometimes useful. But in the severer forms of the disease, 
especially where there is much prostration, they are of ques^- 
tionable utility. 

After the latent energies of the system have been tempo- 
rarily aroused by the above means, we often find minute 
doses of calomel, combined with camphor and Dover's pow- 
der, are eminently useful, care must be taken, however, that 



JSIViSON ON MALIGNANT EPIDEMIC, 36 

too free evacuations of the bowels are not produced. Con- 
jointly with these remedies, we must support the energies of 
the system by the use of quinine, brandy, carbonate of am- 
monia, serpentaria, etc., as the case requires. It is some** 
times truly surprising that such enormously large doses of 
these medicines can be borne with impunity. The doses 
should be regulated by the effect rather than the quantity. 
Ordinary doses often make no impression whatever, and if 
the practitioner, from over caution, confines himself to mo- 
derate doses when the energies of the system are sinking, 
the patient will certainly fall a victim to his timidity. 

In many cases opium was found to be an invaluable reme- 
dy. It is specially indicated where there is pain in the head, 
accompanied with delirium, spasm, great restlessness, neu* 
ralgic pains, palpitation, great irregularity of the pulses, sub- 
sultus, etc. The great cerebral disturbance might seem to 
contra-indicate the use of opiates ; experience, however, has 
shown that it may not only be given with safety, but that in 
many cases it is essential to the cure. Like tonics and sti- 
mulants in this disease, it often has to be given in large 
doses, and continued for a considerable length of time, and 
when it becomes no longer necessary, it should be gradually 
withdrawn. 

The bowels should be moved by the mildest laxatives and 
laxative enemata ; active cathartics are totally inadmissible. 
Cases that previously were doing well, have sunk rapidly, 
and died in a few hours after the operation of a moderate 
cathartic. It will not do, however, to be indifferent to the 
condition of the bowels. One case was noticed that came 
near falling a victim to an overloaded state of the alimenta- 
ry canal. No evacuations had taken place in several days ; 
the extremities were cold, pulse 40 and extremely feeble, 
great prostration, countenance sunken, abdomen tumid but 
not tender ; a tolerably free evacuation of the bowels brought 
great relief; the same unpleasant symptoms occurred in this 
patient every time the bowels were allowed to become ob- 
structed. 

If any organic disturbance occurs, attended with local in- 
flammatory symptoms, it must be met by the treatment ap- 
propriate to these affections. It is necessary to bear in mind, 
however, that the condition of the system is decidedly that 
of adynamic, and if any antiphlogistic remedies become ne- 
cessary, they must be of the mildest character. Among 
these secondary affections, perhaps pneumonia and hepatitis 



86 2SRICKELL ON INTERMITTENT AND REMITTENT FEVERS. 

occur most frequently. In these, and various other affec- 
tions, dry cupping is often of service. Blisters are among 
our most useful remedies ; a large amount of surface should 
be covered, and kept open as long as the inflammatory 
symptoms remain. 

During the course of the convalescence the utmost care 
should be exercised to prevent relapses. Every symptom., 
however insignificant, should be closely watched; any un- 
necessary exposure of the person should be avoided, especi- 
ally in cold, damp weather. Cold night-sweats are common 
during convalescence, thus rendering patients peculiarly lia- 
ble to take cold from slight causes. These sweats should be 
controlled by the appropriate remedies. A uniform tempe- 
rature of the sick chamber, through the night as well as day, 
is specially important. The diet should be light, but suffi- 
ciently nutritious. Too much attention cannot well be paid 
to these regulations, and they should be persisted in until the 
health is completely re-established. 

A case of a young man occurred, who had so far reco- 
vered that he was considered well ; he continued so for two 
weeks. In a cool, damp day he rode some miles from home, 
went without his dinner, returned and ate a hearty meal, 
was taken with a violent relapse in the evening, and died in 
forty-eight hours. It is probable in this case, that the expo- 
sure in going from home and returning, had quite as much 
to do with bringing on the relapse as the error in diet. 

I had designed to subjoin the outlines of a few cases illus- 
trating the phenomena and treatment of this disease ; but I 
have already exceeded the bounds that I had prescribed, 
and I shall therefore omit them.— N. Y. Journal of Medicine. 



On the Modus operandi of Quinine in Intermittent and 
Remittent Fevers, By D. Warren Brickell, M. D., 

of New Orleans. 

Messrs. Editors,— In the July number of the "American 
Journal of the Medical Sciences," we find some very inte- 
resting "Notes of Hospital Cases/* from the pen of Dr. H. 
Hartshorne of Philadelphia. Amongst others, he mentions 
some cases of intermittent and remittent fevers, treated by 
Dr. Gerhard, and volunteers the following deduction. 

"The impression was formed, that of the two elements of 
fall fever— the febrile condition and the miasm- cause— -it m 



BRICKELL ON INTERMITTENT AND REMITTENT FEVERS. 37 

the latter only that is addressed by the remedy in question. 
It arrests fever by acting as an antidote to the poison which 
produces it. 

"Can such facts, then, point to its use with a similar in- 
tention in the exacerbations of other fevers, entirely differ- 
ent in cause, as the typhus and typhoid ? Certainly not/' 

Now, may we be allowed to ask of Dr. H. what this "mi- 
asm-cause" is? What is its form, consistency, chemical 
composition ? Is it either visible or tangible ? Indeed, we 
should be most happy to have anything connected with its 
histor)?-, anything which is beyond the pale of disputation, 
anything veritably established. Moreover, such information 
being furnished us, we would be pleased to know the action 
of quinine on this " miasm-cause" out of the human body, 
either chemically or otherwise. 

In the mean time, however, we will take it for granted 
that nothing is as yet known of the nature of this supposed 
element, and venture a few humble animadversions on the 
deductions of the writer. 

If, as we assert, we are all in total ignorance of the na- 
ture of the element, what right has the writer to imagine its 
presence in the system during an attack of intermittent or 
remittent fever ? How very difficult is it frequently to de- 
tect the presence of, or to remove foreign bodies, causes of 
disease, even where they possess all those physical charac- 
teristics which tend to render them evident in every sense of 
the word ! Again, remove the foreign body, a splinter, a 
nail, &c, or allow nature herself to perform the task; days 
elapse, during which time the patient appears to be doing 
well ; suddenly, however, tetanus supervenes ; the life of the 
patient is threatened, notwithstanding the removal of the ori- 
ginal cause. Shall we still suppose the presence of this 
cause, and resort to the knife, its only antidote ; or shall we 
address our remedies to the symptoms of the patient ? Sup- 
pose a man is laboring under what is called " coup de so- 
lid;" in this case the cause of the disease, although subtle, 
is more evident than the " miasm-cause ;" but do we ad- 
dress our remedies to the sun? Have we any right to sup- 
pose the existence of the sun or its causative emissary in the 
body of the patient ? 

But let us approach the bed-side of a patient. We find 
him with hot and dry skin, accelerated pulse, indeed all the 
symptoms characterising that state ordinarily denominated 
fever. ? Tis a case of remittent fever, and we find him in 



38 BRlCKKLL ON INTERMITTENT AND REMITTENT FEVERS 

the midst of an exacerbation. He tells us he is six days from 
Wilmington, N. C; that he was taken sick the day after 
leaving said port ; has had an exacerbation of fever every 
day during five days. We administer 15 to 30 grains of 
quinine ; in three hours his pulse is very much reduced ; his 
skin is bathed in a free perspiration ; no pain ; sleeps quiet- 
ly ; we all agree that this change of condition is attributed 
to the quinine. 

Now the question arises, whether the remedy acted on the 
cause of the disease, (of which we are most profoundly ig- 
norant,) or on the man himself. If on the cause, we should 
be highly gratified to be furnished with the data for such a 
conclusion, together with something explanatory of the 
change produced in the condition of the man— as the reduc- 
tion of the pulse, free perspiration, &c. Surely the writer 
will not contend that the antidotal effect of the quinine on 
the " miasm- cause" within the man, has any agency in ef- 
fecting this happy change. For our own part, the pheno- 
mena consequent on the exhibition of quinine, have always 
impressed us with the belief that the agent acts on the man 
himself, and it must be something more powerful than a 
mere supposition, a theory that can convince us to the con- 
trary. When we apply sinapisms to the cold extremities of 
a patient laboring under congestive fever, (a so-called mias- 
matic fever,) and a rube-facient effect is produced, thereby 
in a great degree improving the condition of the man, we 
can readily conceive of the action of the remedy on the part 
to which it has been applied but it must be a great stretch 
of the imagination to think for a moment that the cause of 
the disease has been acted on by the mustard. 

But quinine sometimes fails to cure fever, or, in Dr. H. J s 
view of the question, to antidote the cause. How does the 
writer account for this ? Such cases, too, will often yield 
very readily to arsenic ; sometimes to opium ; sometimes to 
the purgative plan of treatment. We have seen cases of 
mild remittent fever cured by the application of the cold 
douche. Are all these remedies antidotes to the " miasm- 
cause" ? &c. 

However, we think the Dr. abandons his own position 
even before the sound of the enemy's trumpet reaches his 
ear. In one sentence he says, " It (quinine) arrests fever by 
acting as an antidote to the poison which produces it." And 
the second sentence after this, he says, "The writer saw no 
facts, in any case of its administration, to justify any other 



THE CHOLERA— ITS COURSE AND RAVAGES. fjf) 

appellation for its effects than those of tonic and nervous sti- 
mulant.'* 

" Tonic and nervous stimulant" of what ? Not of the 
" miasm- cause ;" but of the patient to whom the remedy 
was administered. He acknowledges this " tonic and ner- 
vous stimulant" effect ; and yet asserts that it is the " mi- 
asm-cause" only, which is addressed by the remedy. To 
us all this seems " confusion worse confounded." Despite 
the careful "operation of displacement" to which the author 
has subjected the "miasm cause" this imaginary something 
— or rather, nothing — is found to be (in the ordinary phrase- 
ology of the day.) about "as clear as mud." 

When the writer has personally tested the efficacy and mo- 
dus operandi of the "large quantities" of quinine adminis- 
tered by "some southern practitioners," the latter will more 
willingly listen to his speculations concerning the probable 
causes of the sedative action on the pulse, whether it is, "ce- 
rebral oppression, analogous to narcotism, or the antidotal 
influence above spoken of." He acknowledges that he has 
never administered the medicine in these "large quantities," 
and whilst we would most earnestly recommend the prac- 
tice, we must contend that his present deductions are, to say 
the least of them, premature. 

Whether quinine should be administered in typhus and 
typhoid fevers "with a similar intention," — its antidotal in- 
fluence over the " miasm-cause" — we will not pretend to 
argue ; perhaps the causes of these fevers — typhus and re- 
mittent — are totally different. One thing, however, we will 
venture to say ; if the writer will administer 30 or 40 grains 
of quinine, combined with a grain or two of opium, to cases 
of typhus and typhoid fevers in the commencement of the 
attack, we think he will find the agent quite as efficient in 
checking these- fevers as it is in checking the so-called mias- 
matic fevers. These results we have repeatedly witnessed, 
but we have never yet concluded that quinine is an antidote 
to the cause of typhus fever. — Medical Examiner, 



THE CHOLERA— ITS COURSE AND RAVAGES. 

The cholera has now swept over the entire extent of the 
Mississippi Valley, as an epidemic, and spent its force at 
nearly all important points. Its deadliest ravages have been 
at New Orleans, St. Louis, Quincy, Nashville, Lexington, 
Cincinnati, Sandusky city, Lafayette and Buffalo. Of towns 



40 THE CHOLERA — ITS COURSE AND RAVAGES. 

and cities of considerable size that have been visited by it, it 
has fallen most lightly on Mobile, Natchez, Vicksbnrg, Lou- 
isville, Wheeling, Detroit, Cleveland, Columbus and Pitts- 
burgh. The small towns in which it has raged worst, are 
Bellville in Illinois, Lebanon in Tennessee, Paris and Rich- 
mond in Kentucky, Aurora, Boston and Napoleon in In- 
diana, and Eaton, Vandalia and Minster in Ohio. Places 
that have suffered a good deal, and yet cannot be classed 
among the worst, are Chicago, Alton and Peoria in Illinois, 
Memphis and Clarksville in Tennessee, Maysville in Ken- 
tucky, Richmond in Indiana, Xenia, Dayton, Springfield and 
Batavia in Ohio. " The Coast" at Louisiana has also suf- 
fered a great deal from first to last, 10 to 25 per cent, of the 
slaves being carried off by the disease on the principal plan- 
tations. Places of considerable size which have either near- 
ly or altogether escaped the visitation of the pestilence, are 
Jackson in Mississippi, Little Rock in Arkansas, Huntsville, 
Tuscaloosa and Florence in Alabama, Knoxville in Tennes- 
see, Glasgow, Shelbyville, Frankfort and Georgetown in 
Kentucky, Cairo and Springfield in Illinois, New Albany, 
Madison and Indianapolis in Indiana, and Zanesville, Steu- 
benville, Marietta, Chillicothe, Hamilton and Rossville in 
Ohio. 

Here, now, are singular facts, plainly showing the myste- 
rious and capricious character of this dreadful disease. It 
appears here, there, elsewhere, suddenly, and often giving 
no warning, without reference to lines of travel, regardless 
of natural water courses, wholly independent of the direc- 
tion of prevailing winds, and uncontrolled by the topographi- 
cal character or geological formation of the district within 
its general course. Spending itself where it lights first, 
either gently or ferociously, it disappears, and while neigh- 
boring points are standing in awe of its proximity, and daily 
expecting its desolating presence, it suddenly appears in al- 
together another region, a hundred or two miles away. And 
again, two or three weeks, or two or three months after- 
wards, while those who seemed to have escaped are still 
warm in the congratulations of each other, and are begin- 
ning to talk and write about the superior healthfulness of 
their towns, the destroyer retraces its steps, strikes at their 
best and their worst, their strong and their feeble, alike, and 
carries mourning to every household. 

This is the manner in which the cholera has appeared and 
disappeared in the course of its march over the Mississippi 



THE CHOLERA — ITS COURSE AND RAVAGES. 41 

Valley. For weeks it is at New Orleans, and does not ap- 
pear at Natchez, or Vicksburg, or Memphis, although the 
the intercommunication is incessant ; for even months it is 
in that city, and does not appear in Mobile at all, except in 
the instances of three or four persons who came home with 
the disease developing in their systems, and die of it. It ap- 
pears at St. Louis, and scourges that city as no other Ame- 
rican city has been scourged ; and yet for the space of five 
months the city of Alton, a few hours' travel above, on the 
same river, and in daily, we may say, hourly communica- 
tion, does not feel its presence in a single case. 

Then Alton is stricken, and in a fortnight many of her 
best citizens are borne to the grave, while the vile look on 
and escape. It leaps to Cincinnati, moving over hundreds 
of miles of populated country in a direct line, and passing 
by many towns and cities on the water line of travel, and 
for two months subjects us to its terrible ravages, carrying 
off thousands of our people. Yet while this is going on, a 
populous city but little more than a hundred miles from us, 
nearly altogether escapes its presence, and many smaller 
towns, at half that distance, remain wholly exempt from its 
visitation. Then it leaps sixty miles north to Dayton, a city 
of 12,000 to 14,000 inhabitants, and eighty miles south to 
Lexington, a city of 7000 to 8000, and fills their cemeteries 
with new-made graves, while the intermediate towns, with 
their populations of 1000 to 5000 each, experience entire 
immunity. In the rural districts, too, the same capricious- 
ness is shown. In some counties almost every town of from 
100 to 300 inhabitants has witnessed the presence and the 
ravages of the disease, while in adjoining counties even its 
breath has not been felt. 

And now, having moved thus capriciously from one ex- 
treme to the other of this great valley, it threatens to return 
upon its track, and wrap in darkness and desolation the 
places that till now it has spared. This, indeed, is what it 
has already to some extent done, in so recently striking Le- 
banon in Tennessee, and Harronsburg in Kentucky, and 
Springfield in Ohio, and Birmingham near Pittsburg, and 
some other places near which it showed itself a month or 
two ago, and from whose vicinity it had almost entirely dis- 
appeared for weeks. — Cincinnati Gazette. 
5 



42 STRICTURE OP THE (ESOPHAGUS. 

STRICTURE OF THE (ESOPHAGUS. 

One of the most extraordinary cases of stricture of the 
oesophagus, known to us, now exists in a shoe-maker, of 
Boston, who actually keeps himself alive by the habitual 
practice of an operation that no surgeon in New England 
would dare perform in the rough manner pursued by this 
unfortunate sufferer. He is a small man, rising of 70 years 
of age. For many years he had extreme difficulty in swal- 
lowing food. Deglutition finally became so painful, that he 
took advice at the Mass. Gen. Hospital, and, according to 
his own representation, an instrument was introduced down 
his throat. The relief was not entirely satisfactory ; but 
discovering that the principle was right, since there was evi- 
dently a narrowing in the canal, the idea was conceived of 
practising upon himself. At the extremity of a rattan, per- 
haps a yard in length, and a quarter of an inch in diameter, 
he wound on a mass of hemp, which was confined by twine. 
A rough mass, six inches long on the stick, and an inch 
thick at the lower extremity, was thus made. Having oiled 
it, the old man fearlessly forces it down through the oesopha- 
gus, fairly into the stomach. This he is obliged to do fre- 
quently, otherwise the strictures — for there are two, one just 
at the top of the sternum, and the other a little above the 
cardiac orifice — become so closed, that fluids cannot pass at 
all. Sometimes, after swallowing a draught of water, it is 
stopped at the lower constriction. To relieve himself, under 
such a dilemma, he thrusts down a long feather, which pro- 
duces nausea, and by the sympathy of the gastric apparatus 
vomition is induced, and the confined fluid, according to his 
account, forced back. Sometimes food is checked in its de- 
scent, at the same point, and ejected by mechanical assist- 
ance. 

On Tuesday, of last week, after giving us a minute histo- 
ry of his condition, the narrator oiled the monstrous pro- 
bang, forced it down into the stomach, and brought it back 
dripping with gastric juice. Not long since, the lower 
stricture utterly refused to allow the great swab to pass. 
Recollecting that tobacco was a relaxer, while the rattan 
was protruding above his teeth he calmly lighted a pipe, 
and by taking only a few whiffs had the satisfaction of re- 
laxing the muscular grip, and down the mass went, passing 
the rebellious point into the great membranous receptacle 
below. On one occasion, the probang was coated over with 



H0LST0N ON CHRONIC HICCOUGH. 43 

ground mustard, and thrust through the strictures, on the 
supposition that they required stimulating ! 

A more singular case, one more truly formidable in cha- 
racter, and managed in the rude, fearless manner here de- 
scribed, cannot be found, it is believed, in the annals of sur- 
gery. Under any plan of treatment but his own, this man 
of ten millions would have been dead, years ago, a victim 
to an incurable malady. With the course he is habitually 
pursuing, life may be protracted till he is unable to repeat 
the operation, and then he may die of starvation.- — Boston 
Medical and Surgical Journal. 



Chronic Hiccough of Seven Years Standing, following 
Whooping Cough, cured by Strychnine. By John G. F. 
Holston, M. D., etc. of New Concord. 

\ Hiccough, though more generally a symptom in other dis- 
eases, sometimes assumes a more independent form and be- 
comes troublesome from its long continuance, and dangerous 
from the violence of its paroxysms, threatening suffocation. 
A number of cases are on record of hiccoughing continued 
for several months — but the following one, on account of its 
long duration and its obstinate resistance to most energetic 
treatment appears to me somewhat unique and worthy of 
being preserved on the pages of the Medical Reporter. 

About eighteen months ago, Margaret M'Nary, aged 
about twenty-five years — the subject of this article — a tall, 
slender girl, of fair complexion, brown hair and dark blue 
eyes, rather handsome, though somewhat emaciated, was 
brought to my house by her brother, a distance of forty miles. 
She was weak and exhausted by her journey, but otherwise 
apparently, in the enjoyment of good health. She gave the 
following account of her disease : 

In the summer of 1S41, she had an attack of whooping- 
cough, which was treated by domestic remedies for about 
four weeks, when it suddenly, without apparent cause, 
ceased and left her for about five weeks in the enjoyment of 
pretty good health. As suddenly, without any premonitory 
symptom or any exciting cause, physical or psychical that 
she knows of, she awoke in the middle of the night with the 
first paroxysm of her present disease. The paroxysm was 
excessively severe, so that she, as well as her family, whom 
she had succeeded in arousing, thought her dying. She had 
several paroxysms that night and for several consecutive 



44 HOLSTON ON CHRONIC HICCOUGH. 

days — when they subsided without seeming to have been 
influenced by the bleeding, purging, antispasmodics and opi- 
ates, that constituted her treatment at that time. The pa- 
roxysms from that period continued to recur at irregular in- 
tervals ; sometimes a few days only would elapse; at other 
times she would be clear of them for two weeks at a time. 
She generally had a number, often thirty or forty parox- 
ysms, with very short intervals of rest. Night and day she 
was equally exposed, and atmospheric vicissitudes and 
changes of season, seemed not to exercise the slightest influ- 
ence over the disease ; neither could she discover that it was 
under the control of her diet ; and though her appetite be- 
came greatly diminished, she relished her meals as usual 
and had no unnatural cravings. She thought her spells (as 
she calls them) somewhat more likely to recur, when she 
had an attack of sick-headache, or toothache, and always 
had a few moments warning, which she instinctively em- 
ployed in loosening her clothes and preparing herself for the 
attack. During the paroxysm, but at no other time, her 
mind became excited and somewhat confused. A few deep 
sighs would usher in the seizure, when she usually ejacu- 
lated some phrase, such as : "I must die, I can't live." The 
hiccough commenced and soon became so violent as to make 
a continuous choaking, strangling noise ; the muscles of the 
chest and abdomen, were in a rapid wave-like motion, till 
they ceased, apparently worn out by their own violence. As 
might be expected, she had consulted doctors by the dozen 
and was subjected to every variety of treatment. Her attend- 
ants generally revenging their want of success by declaring 
she was hysterical; and one (certainly not a gentleman) af- 
ter failing to cure her by a vile mixture of assafcetida and 
balsam copaiva, told Lor she had (a new name in medical 
nomenclature) the man-sterricks! ! She would have become 
disgusted with the whole medical profession had not her ur- 
gent distress driven her again and again, to seek relief, which 
she partially got under tha kind and skillful treatment of Dr, 
McFarlan of Washington, Guersney Co., who succeeded in 
suspending the paroxysms for a couple of months, hy insert- 
ing a seaton in the bark of the neck and giving ferruginous 
preparations internally. Soon, however, she was as bad as 
ever and then came to me. 

The obstinacy and obscurity of the case induced me, be- 
fore commencing a course of treatment, to make repeated 
and most careful examinations, but I failed in discovering 



HOLSTON ON CHRONIC HICCOUGH. 45 

any organic lesion, except a number of rotten teeth, caused 
by a course of mercury to which she had been subjected 
during the treatment of her disease, and no functional de- 
rangement but a very great increase of the salivary secre- 
tion, which kept her constantly spitting ; menstruation and 
defecation were performed with exact regularity. I was 
forced to consider the case, what Tissot and others of the 
older writers would term a nervous metastasis (I know of no 
better term) to the phrenic nerve, which its connection 
with the par vagum render explicable enough. 

I commenced treatment by using the metallic tonics; first 
iron, then zinc, copper, bismuth, to no effect. Arsenic I was 
deterred from using by the length of time, she probably might 
require to use it — during this time I also extracted the cari- 
ous teeth. I next employed narcotics, sometimes alone, 
sometimes in conjunction with the preceding remedies. 
Stramonium, hyoscyamus, belladonna, cicuta — all had their 
turn. All arrested the spitting, suspended the paroxyms, 
but caused headache and other uneasy sensations, which 
were only relieved by the hiccough returning with redou- 
bled violence. 

I next used quinine in small as well as large doses, to no 
purpose ; then shower bath and electro-magnetism with no 
result. Being driven to my wits' end, I determined to try 
to break up the habit, for such it certainly had become, by 
substitution of action and put her on the use of strychnine. 
R. Strychnine, grs. iv. 
Water, oz i. 
Sulph. acid, M. v. — M. 10 drops every S hours. 

For two weeks she took this prescription without any 
sensible effect, but a slight diminution of the spitting, when 
suddenly, as she was spinning at the big wheel, she was 
seized with a tetanic spasm ; her legs were jerked up ; her 
head bent back ; her jaw set, and she fell on the floor almost 
senseless. Having removed myself to within thirteen miles 
of her residence, I was sent for in great haste, and on my 
arrival, found the muscles of the jaw yet rigid and the spine 
bent backward ; pulse strong and full ; a little headache 
and a severe pain in both sides, in the regions of the dia- 
phragm ; shudderings with increase of spasms passed over 
the whole frame every five minutes. I bled her twenty 
ounces, gave Epsom salts, oz i. with 

Laudanum, gtt. x. 
The spasm relaxed; she fell asleep, (about 10 o'clock at 



46 DIXON ON MALARIA. 

night) the next morning her purgative operated and she was 
in her usual health. This was in December last. I directed 
the strychnine to be continued in smaller doses and occa- 
sionally suspended. She had several slight tetanic seizures 
afterwards, but the paroxysms of hiccough gradually be- 
came weaker and less in number, and for more than four 
months she has been entirely free from them. She took the 
strychnine about two months. Her troubles were, however, 
not ended. As the hiccough lessened, she began to feel a 
pain in each side, extending from the middle of the neck on 
each side of the sternum to the edges of the ribs, and thence 
spread right and left. This pain became so violent that I 
was again sent for, but not being able to go, a medical 
friend attended, cupped the sides, applied a blister, and ad- 
ministered pills of calomel, opium and ipecac, without relief. 
In a few days I saw her again, and directed frictions over 
the course of the phrenic nerve with croton oil, which 
brought on extensive pustulation and gave some relief. The 
pain, however, soon returning, I prescribed frictions with 
the following: R. Veratrine, grs. iv. 

Lard, oz i. 

Sulph. acid, M. iv. 
and internally prussic acid, fresh prepared by myself after 
the Dublin formula, 3 drops every 8 hours in water. She 
got relief with the first rubbing and dose of drops, but con- 
sumed about oz i. of the acid and oz ii. of the ointment. She 
is now free from all suffering, but the saliva is still secreted 
too freely and she feels some weakness in the region of the 
diaphragm, but is still improving.— Western Lancet. 



On Malaria. By Samuel Henry Dickson, M. D., Profes- 
sor of Theory and Practice of Medicine in the University 
of the city of New York. 

The etiology of periodical fevers is a topic of permanent 
and absorbing interest. Few subjects have been so often or 
so ably discussed ; the ingenuity of medical theorists has 
found no where so wide and fair a field for its exercise. Let 
us examine, for a moment, the present state of the discus- 
sion. 

Diseases may be divided into the specific and non-specific; 
those which require for their production a special cause, an 
agent of definite and characteristic properties, being designa- 



DICKSON ON MALARIA. 47 

ted by the term specific. Here we would include the conta- 
gious affections, febrile and non-febrile, in all which a nota- 
ble materies morbi may be referred to as necessary for the 
generation or production of the concurrent phenomena. Un- 
der the same head we might speak of delirium tremens, ra- 
chialgia, and spontaneous gangrene from ergot, and the long 
list of influences exerted by the several articles of the mate- 
ria medica: ptyalism from mercury; the sloughing cheek and 
carious alveoli of the phosphorus match maker; nay, the me- 
chanical phthisis of the knife-grinder and coal-heaver might 
be placed here, with the long train of less palpably deve- 
loped results of narcotism by alcohol and tobacco. Beyond 
these our inquiries must invade the domains of conjecture 
and speculation. 

It is, however, among endemics and local epidemics that 
we shall find the subjects of the most difficult research, and 
in this relation, of the highest importance. Why plica po- 
lonica belongs only to one region or people, and pellagra ex- 
clusively to another; why bucnemia prevails specially in 
Barbadoes; trismus nascentium in Iceland, and traumatic 
tetanus in Santa Cruz; why plague and ophthalmia are indi- 
genous to Egypt, and yellow fever to Havana and Cartha- 
gena; why goitre and cretinism besets so grievously the Al- 
pine valleys; and why the rich fields of Lombardy and the 
desolate plains of the Campagna di Roma, are annually ra- 
vaged by periodical fevers; these are questions which, per- 
petually recurring, have hitherto received no satisfactory 
answer. 

To which of these classes of disease, specific or non-spe- 
cific, does periodical fever belong ? This is the first point 
to be investigated; this is the first step in the debate; and if 
the correct direction be not followed from the beginning, we 
must surely be led far astray, in our progress toward a con- 
clusion. 

The prevailing opinion that such fevers are of specific na- 
ture, and derive their "origin from a peculiar morbid agent or 
poison, is maintained, not without some vagueness, I ac- 
knowledge, upon the following grounds: 1. The familiar se- 
ries of concurrent and successive symptoms, the characteris- 
tic phenomena of these fevers, are supposed to be so marked 
as to demand, ex necessitate, a reference to a specific and 
relevant cause. 2. The second position, implied, indeed, in 
the first, is the total inadequacy of all obvious contingencies 
and known modes of causation to account for effects appa- 



48 DICKSON ON MALARIA. 

rently so varying and disconnected with them, yet, under 
other and indefinable circumstances, so uniform and suscep- 
tible of repetition. 3. The a posteriori argument drawn 
from the unequivocal and impressive efficiency of the best, 
if not the only specific remedy known in our materia medi- 
ca, (cinchona and its salts.) 

1. The periodicity of these fevers, so familiar and yet so 
strange a fact, or series of facts, has not been, I think, suffi- 
ciently considered or studied. It is true, that periodicity is 
a very frequent element of disease in general; nay, a certain 
degree of regularity of movement, of alternating or recurrent 
conditions, may, perhaps, be regarded truly as the rule, and 
its absence the exception, in the symptomatology of all mor- 
bid affections. Neuralgia rarely fails to observe this law 
with more or less precision; convulsive maladies generally, 
epilepsy and hysteria more particularly, show its influence ; 
the return of hemorrhages may often be predicted; inflamma- 
tions, irritations and congestions, all are known to recur at 
stated times, and even suppuration is occasionally suspended 
and resumed at exact intervals, as in the tenacious disorder 
of the frontal sinus and antrum maxillare connected with in- 
fluenza; organic changes of structure, scrofulous and others, 
though of course themselves continuous, give rise to hectic 
of diurnal or double diurnal repetition, and the same periodi- 
cal disturbance of the constitution often follows wounds and 
mechanical injuries. It is also true that all the healthy func- 
tions, actions, and habits of the system are either governed 
originally by some law of regular revolution or fall readily 
into a convenient obedience to it; and upon this normal pe- 
riodicity seems indeed to be founded most of the phenomena 
of periodicity belonging to the history of diseases. 

But if any are independent of this analogy, proceeding 
without perceptible relation to it, nay, traversing it freely, 
we may affirm the fact to be true of what are called malari- 
ous fevers. These present a variety of types; they are re- 
mittent and intermittent; quotidian, tertian, and quartan, 
with duplications, reduplications, and interchanges, of great 
complication, and intricacy, yet always preserving a well- 
defined course, and easily unravelled if carefully attended to. 
The quotidian has much analogy with the ordinary move- 
ments of the human system, and is hence the type common- 
ly assumed by fevers which attend upon incidental irrita- 
tions and modes of disturbance, also in all hectics. A good 
illustration of this influence is given in M. Brachet's account 



DICKSON ON MALARIA. 49 

of the production of an artificial intermittent in himself by 
plunging into cold water at a fixed hour for several eve- 
nings in succession. 

The tertian departs abruptly from this analogy. "There 
is" says Watson, "no known bidual habit in health." Per- 
haps we may fairly regard as an exception to his remark, the 
habit of alvine evacuation on alternate days, which seems 
perfectly natural to some men who enjoy good health. But 
this is unimportant. In some of the lower classes of animals 
bidual habits are said to be noted. Knox tell us that in the 
wild goose, swan, and duck tribes, an egg is laid only on 
every second day. 

We lose all hold upon any normal clue in this labyrinth^ 
when, we reflect upon the superposition or accumulation of 
paroxysms so often observed — the herosthesis of the an- 
cients, the tertiana duplex et duplicata, where each day shall 
present its access of fever, yet evidently not quotidian, but a 
tertian repeated, or rather two tertians; or one day shall be 
free from fever, and every other day be burthened with two 
paroxysms; or as in the triple tertian, not very frequent, but 
occasionally met with, I suppose, by every extensive practi- 
tioner in malarious countries, where two paroxysms mark 
every alternate day, a single access presenting itself on the 
less unfortunate days. For such extraordinary phenomena, 
so far removed from ail correspondence with any normal ac- 
tions of the organism; for such striking and impressive, and 
novel effects, we must seek some adequate, novel and rele- 
vant cause. 

The quartan, which rarely in our country commences as 
the original or primary type of an attack of intermittent, is 
usually considered as most remote from any familiar or in- 
cidental analogies. Its history is, indeed, singular. In thirty 
years of practice in a malarious region, I have met with but 
two cases beginning with this type; both in young persons 
between eighteen and twenty-one, one a male the other a fe- 
male; both in the better conditions of life, and as little ex- 
posed as any residents in such a region could be. In gene- 
ral, the quartan makes its appearance as a degenerate ter- 
tian or quotidian. From either of these it is formed in the 
same mode, that is, by the loss or elision of two paroxysms, 
upon or after which there commences the new interval or 
train of progress. The extreme obstinacy of this mode of 
intermittence, or rather recurrence, is matter of universal no- 
toriety. I saw, in 1817, a case of quartan of 15 years ? dura- 
7 



^0 JDICKSON ON M.ALAU1A. 

tion brought to a close. Some few years since a gentleman 
placed himself under my care, who had not missed his quai- 
tan paroxysm once in IS months. The books were formerly 
filled with such instances; now, happily, no longer to shame 
the profession. The subjects of these tedious quartans are 
often apparently in very good health in every other respect; 
stout, robust, corpulent, athletic, with good appetite, sound 
digestion and ready assimilation, performing with alacrity 
all the duties of life, and enjoying all its pleasures. 

The connection of the remittents of malarious districts 
with each other and with intermittents is undenied, and I be- 
lieve undoubted. The analogies of movement presented, 
vary in different instances; but I believe in general they 
will be found to refer to the tertian rather than to any other 
types, the remittent persistence being attributable probably 
to some organic change in the condition of some one of the 
viscera; the abdominal contents being chiefly affected, the 
liver, I doubt not, in the great majority of cases, the spleen 
almost always, the mucous digestive tissue not unfrequently. 
Perhaps the same tenacity may be given to the attack, which 
would otherwise intermit, by congestion, irritation or inflam- 
mation of the vascular apparatus, the lungs and their appen- 
dages and the cerebro-spinal axis with its membranes. We 
can often trace throughout the whole history of a case, a 
correspondence with the periods of the double and even the 
triple tertian. 

Let us take a cursory review of these facts. On a certain 
number of persons residing at a particular spot, a proportion, 
in many places a large one relatively to the whole, shall be 
annually seized with periodical fever. The type will not in 
all be the same. Some will suffer from a fever continuous 
in duration, but notably and regularly subject to variations 
in degree of intensity, and in the concurrent phenomena, 
Others will be assailed daily by a paroxysm coming on at a 
fixed hour and subsiding after a certain duration, leaving an 
interval of freedom from fever for a part of the day. In 
others this interval will last a whole day and more, only a 
portion of every alternate day being annoyed with the fe- 
brile access; and yet in others, still more fortunate, there 
will be two days of comparative, nay, sometimes apparent- 
ly absolute health, to one disturbed with fever. It is agreed 
to ascribe all these diversified attacks to one identical source, 
of whatever nature, because the types not only occur toge- 
ther under precisely indentical contingencies, but they are 



DICKSON ON MALARIA. 51 

all convertible and frequently converted: the remittent often 
subsides into an intermittent, as a stage of convalescence, or 
in seeming convalescence, takes tenacious hold as an inter- 
mittent, the quotidian and tertian degenerate, as the com- 
mon phrase is, into an obstinate quartan. 

The given locality in which all these things happen, is 
sometimes narrowly limited and well defined; they take 
place in the genial months of the year; they seem to be rele- 
vant rather to season, however, than mere temperature, be- 
ing frequent in the coolest spring, summer and autumn, and 
infrequent or exceptional in the warmest winters. 

I will not dwell upon the proofs of the identity of cause 
and nature alleged to be deducible from the organic changes 
impressed by these several types. Our morbid anatomy of 
fever is still unsettled. Broussais found the seat of intermit- 
tent in the mucous membrane of the digestive tube, Schultz 
and Maillot in a lesion of the cerebro-spinal axis, and Piorry 
loudly maintains the exclusive rights of the spleen; while 
Stewardson calls our attention to a special change of ap- 
pearance in the liver as uniformly belong to the history of 
a malarious remittent. For my part, I hold with Fordyce, 
who pronounces fever to be a disease of the whole system 
"in every kind of sense." It is indeed a turbulent congeries 
of irritations, congestions and inflammations; it disorders al- 
ways with congestion, and not unfrequently with conse- 
quent inflammation, every abdominal viscus, the spleen uni- 
formly more or less, the liver also at some period of its 
unarrested progress; and the digestive surface of course, 
directly or secondarily. Nor can the kidneys escape when 
the skin is corrugated and its functions suppressed, or heated 
and dried in every scale; the lung yields somewhat less 
readily than the spleen to the congestion of the cold stage, 
but recovers from it with more difficulty, and inflicts more 
constitutional injury by its morbid condition while its impor- 
tant offices are impeded. As to the cerebro-spinal axis, the 
splenic plexus — nay, the whole sensorial tissue, ganglionic or 
cerebral, the cerebellum or the great sympathetic, nothing can 
be more inevitable than that they all must be involved in the 
wide spread derangements, vascular, secretory and excretory, 
derangements of condition and function and composition of 
solids and fluids, which go to constitute in detail the full his- 
tory of a febrile paroxysm. Yet I think there would be no 
great difficulty in showing that the effects or permanent in- 
fluences of all these types of malarious fever, whether exhi- 



52 DICKSON ON MALARIA, 

bited during their protraction in obstinate modes of ill health, 
or during the successive stages of convalescence, or in the 
autopsy of fatal cases, are closely analogous, extremely 
similar, or absolutely the same; and that they differ from the 
changes impressed by all other forms of fever known to us 3 
arising from whatever sources. 

Now it seems to me logically fair and correct to reason 
backward here, from effect to cause, and from the peculiar 
and specific character of the efTects to infer a relevant speci- 
fic and peculiar character in the cause. Incidental influ- 
ences of familiar nature, acting in access or by unadapted- 
ness, produce impressions cognizable by their resemblance to 
those which they normal^ excite, the difference being in, 
degree alone. But here, new movements have been origi- 
nated, rythmical, so to speak, and tenaciously preserving a 
regularity which corresponds with nothing belonging to the 
healthy processes of the system: there is besides, something 
in the mode of causation of each ease, which decides the train 
of movements in that case, making the periodical revolution 
diurnal, bidual, or tridual; bringing on a chill in one every 
day in the morning, in another a similar chill at noon every 
second day, and still another in the afternoon of every third 
day. In one the head shall be prominently affected, in a 
second there shall be vomiting and tormina, and in a third 
the spleen, or liver, or kidney, or spine, shall be the seat of 
painful engorgement or inflammation. A fourth shall have 
no repetition of the chill which usually ushers in the pa- 
roxysms, but be regularly re-attacked at precise intervals 
with fever, commencing with the hot stage, or shall enjoy no 
absolute intervals, but suffer from a continuous hot stage, 
varying in degree of intensity, and in its undulations of vio- 
lence exactly corresponding with the movements of some one 
of the types which intermit. This endless variety of identi- 
cal or closely analogous impressions, preserved so often with 
an almost indescribable exactness through the whole duration 
of certain cases; in others, again, palpably intermingled, as 
though one attack of fever were removed or one superadded 
upon that or those previously existing — all this I say, irresis- 
tibly leads me to the belief of a specific cause, a poison 
acting peculiarly and characteristically upon the organism in 
its own exclusive mode. 

This belief is strengthened by reflection upon another of 
the most notable circumstances in the history of malarious 
fevers. There is, as is well settled, a fixed period of time 



DICKSON ON MALARIA, 53 

between the efficient exposure to the cause, whatever it may 
be, and the first access of definite disease. Sometimes the 
health of the subject is entirely undisturbed during all this 
-time; occasionally there is gradual deterioration and pro- 
gressively increasing ailment. Rarely, this imperfect de- 
rangement is persistent or protracted indefinitely, and seems 
to wear away or subside gradually, unless some exciting 
cause shall disturb the system and arouse the latent disease. 
But all incidental morbid causes act upon the system directly 
when applied; they may require it is true, some continuance 
of application, some accumulation of impulse or impetus to 
overcome the elastic resistance offered by the vital forces, 
but. when this acme is reached, they produce their results 
without delay or interval. Specific causes, on the other hand, 
all need time for the gradual maturation or development of 
their influences. It is probable that by increase of amount 
administered, or by intensity of concentration, they maybe 
made instantly efficient; but this is the exception, not the 
rule. We read of malarious fevers ensuing at once upon ex- 
posure, but in this country we see none such. A latent peri- 
od, very distinctly marked when the exposure has been tran- 
sient, and 1 believe, always relevant to and corresponding 
with the intercurrent period of the type to be assumed, 
passes away before the access of fever. In our southern 
lowlands, this latest period is seldom less than one week, or 
greater than three in duration, but the books give us many 
histories of being indefinitely lengthened, as in the unfortu- 
nate Walcheren expedition. 

In this part of its history, malarious fever certainly re- 
sembles the specific contagions, which require a definite time 
for the development of their influences. Let it be observed 
too, and this is another point of similar analogy, that a con- 
tinued application of the same agency — as by residence in 
the locality supposed to be of morbid force — does not in- 
crease the violence of the impulse or effect, any more than 
continued exposure to the contagion of small-pox or measles, 
or the introduction of a larger quantity of virus by inocula- 
tion will increase the force of their attack. It is equally vio- 
lent, if after efficient exposure we remove the subject far 
away; nay, it is a common opinion in the South, and one 
founded upon long experience and large observation of facts, 
that an attack which follows removal from the malarious at- 
mosphere during the latent period, is apt to be decidedly 
more violent and dangerous than if the subject had remained 
where he received the "seeds of the disease," 



|>4 DICKSON ON MALARIA. 

2. It may now seem unnecessary to press the argument of 
the inadequacy of incidental causes to originate the marked 
phenomena of which I have been speaking, but let us consi- 
der it for a moment. If we observe the patient beginning 
to succumb to the febrific influences at noon of the hottest 
day of summer, in a hot climate, we shall find him shivering, 
with his skin shrunk, corrugated and chilly, while he com- 
plains of the sensation of profound cold,* the thermometer 
standing at 80° of Fahr. or above it. The most ingenious 
and able opponent of the hypothesis of the existence of a fe- 
brific poison, known or unknown, such as we for conveni- 
ence sake designate malaria, Dr. J. Bell, of Philadelphia, re- 
gards the familiar variations in the notable conditions of the 
atmosphere, alternations of temperature more especially, as 
the efficient causes of the so-called malarious fevers. But in 
the low country of the Southern United States, where these 
fevers abound, we meet with them in masses during the 
warm months of the year, from May inclusive, annually. 
In most seasons the heat is then protracted and steady, pre- 
senting in many of the most sickly localities little variation 
in the course of the 24 hours. The coolest portion of the 
whole, (the few hours between midnight and sunrise,) is 
spent in bed, in a more or less sheltered condition; and few 
expose themselves until the temperature of the air is raised 
by the presence of the sun, and that of the body by food. 
For weeks together the heat of the body is not subjected to 
a variation sufficient to produce a sensation of coolness, ex- 
cept in those who sleep in the open air or those who bathe 
in cold water. But these are not .known to be more fre- 
quently attacked by fever than others; nay, the cold bath is 
by many considered prophylactic, and the black, who often 
sleeps out of his house, is less liable to be assailed than his 
protected master. Again: the month of June, presenting a 
high average temperature, is remarkable for its impressive 
alternations. Here we are apt to find the hottest day of the 
year; here, also, we have some cool weather with annual 
certainty. The "sheep storm," "the cold week," are fami- 
liarly spoken of, as to be usually expected ; a change attri- 
buted by one of the most observant meteorologists, I know 
not how correctly, to a temporary extension of the range of 
trade winds along our coast. During this very week, (June, 
1849,) the thermometer has ranged from 54° to 96°, and one 
from 70° to 92°. Yet June is one of the healthiest months 
of the year; indeed, the bills of mortality in our Atlantic 
cities will probably show fewer deaths in June and July than 



DICKSON ON MALARIA. 55 

m any other two successive months. Certainly it is not 
marked by any special prevalence of periodical or malarious 
fevers, nor is their number increased during the cold spells 
to which I have referred. 

Farther: it is a matter of notoriety, that in the malarious 
neighborhood of the city of Charleston, S. C, our most salu- 
brious winds in summer and autumn are those from the east, 
because, as is supposed, they bring us a pure air from the 
ocean. They are moist and chilly, however, and excite ca- 
tarrhs, and rheumatism, and croups, in children and invalids, 
but they lessen the frequency of our climatic and periodical 
fevers. These two sets of diseases seem to be placed in a 
sort of positive contrast to each other instead of being allied, 
as maintained by Dr. Bell, who says, that "in the winter, a 
man who gets cold contracts angina — in spring, pleurisy — in 
summer, cholera-morbus or bilious colic, remittent or conges- 
tive fever — in the fall, intermittent"; and that "periodical 
fevers are most frequent and violent in climates, and locali- 
ties and seasons marked by the greatest contrasts and alter- 
nations in the sensible states of the atmosphere." He adds, 
also, "worse by far than inspiring marshy air in autumn wilt 
be sleeping one night between damp sheets." 

Let us inquire, then, where the greatest contrasts and alter- 
nations in the sensible states of the atmosphere are found in 
our own country, and the relation of malarious fevers to these 
changes. Along the low lands of our southern coast, from 
the Rio Grande to the Housatonic, these maladies are of fre- 
quent occurrence; unfailing in regularity and terrible in vio- 
lence as we proceed southwardly. They are not met with 
on the Merrimack or the Connecticut; they prevail fiercely 
at the mouth of every river opening into the Gulf of Mexico. 
Now, taking either the annual or the daily range of the mer- 
cury, we shall certainly find the thermometrical changes 
most impressive north of the Hudson. Of the alternations 
in barometrical and hygrometric conditions, we are not in- 
formed.* Let us, again, compare the valley of the Housa- 



*The country around Boston is liable to more and abrupter variations 
of temperature, whether we compare those of the several seasons of the 
year, or the diurnal changes in every season, than the neighborhood of 
Mobile, Augusta or Savannah. It should, therefore, upon the theory I am 
combatting, be liable in greater degrree to malarious fevers, but it is both 
comparatively and absolutely free from them. I know not that the Island 
of New-York differs materially in climate from Staten Island; it is said 
that the nights are cooler on the latter, from the sea breezes. They are ai- 



58 DICKSON ON MALARIA. 

tonic, or any other river in New-England, with the low 
lands on Broad or Tiger, in South Carolina. I will not 
speak of Cooper or Ashley, or Savannah or Pedee, whose 
banks are deadly to the white man in autumn. The sensi- 
ble atmospheric contrasts are quite as great, nay, decidedly 
more marked, in the former; the winters of the midland 
southern country are milder, the extreme heat of the sum- 
mer noon not greater, nay, not so great; the day no warmer, 
and the nights by no means so refreshingly cool; yet there 
we find, with less sensible alternations of atmospheric con- 
dition, a constant prevalence of periodical fevers, unknown 
to our northern brethren. 

I know no region so perfectly free from these fevers, and 
indeed from all affections enumerated among the malarious^ 
as the beautiful and healthful plateau which lies in Hender- 
son and Buncombe counties, North Carolina, between the Al« 
leghanies on the western slope, and the French Broad river 
or Saliko. It this earthly paradise, human health it at its 
highest point, both during the cold of winter and the heat of 
summer. The soil is fertile along the banks of the river, and 
the air and water of unrivalled purity. But the climate pre- 
sents impressive and rapid alternations. However warm 
may be the genera! noon the nights are always cool. Where, 
then, should periodical fever prevail if not here, supposing it 
to be produced by these contrasts? Yet if the whole popu- 
lation of that "happy valley" should "sleep in damp sheets 
in autumn," not one would be attacked by intermittent or re- 
mittent fever. Such an attack has never happened to any 
resident there since the first pioneer settlement was made on 
the expulsion of the Indians. Yet these fevers show them- 
selves there sometimes, and in their most violent forms too ? 

most of the same geological structure and soil, or at any rate there is no 
strong contrast; but the difference between them of liability to intermit- 
tent fevers is very great and familiarly known. 

In Farmington, Conn., where I am now writing, (June 23, 1849,) the 
winters are long and very cold ; the summers, though short, are very hot, 
In the most sheltered parts of the house, the thermometer for the three 
past days has risen to 90°, 92°, and 92°, Fahr. The daily range is often 
great ; it was yesterday not less than 22 degrees being 70° at 6 A. M., and 
92° at 3 P. M. During the week it has varied 42 degrees. Here, then, 
we have as high heat as in the middle districts of South Carolina, or the 
western part of the State of New York, and a cold altogether unknown 
to the former. We have also an impressive difference between the re- 
freshing coolness of night and the noonday heats, which does not exist 
there; but here malarious fevers are absolutely unknown; there they are 
annually certain, and extensively endemic if not epidemic. 



DICKSON ON MALARIA, 57 

in persons who travel thither from the low lands of Georgia 
and the Carolinas on one hand, and of Tennessee and Ken- 
tucky on the other. I saw two such there; one was a dis- 
tinguished statesman and orator, destined, had he lived, to 
the loftiest elevation, nay, already elevated to an acknow- 
ledged equality with the highest. His valuable life was sa- 
crificed by the exposure of, probably, a single night only in 
a malarious locality, about a fortnight before he was assailed 
by a malignant remittent. Of the hundreds or thousands who 
pay a yearly visit to this delightful region, subjecting them- 
selves to the strikingly impressive contrast of the tempera- 
ture of this elevated mountain country with the steaming 
plains of the Atlantic coast, or the close valleys of the western 
rivers, it is very seldom indeed that any one who, on his jour- 
ney thither, has exerted common prudence in the avoidance 
of an "unhealthy" locality — a malarious spot, for his night's 
sojourn, has been assailed there. Residing there several 
summers, I knew of no more than two of this kind, already 
mentioned, both of them distinctly referrible to conscious ex- 
posure. Contrast this liability from sensible atmospheric 
alternations with the risk so well understood in our southern 
country. If any man of the white race should sleep in the 
dryest sheets, in the most comfortable apartment of any house 
on any rice plantation, in the most balmy summer or autumn 
night, in our southern low country, selecting the season of 
most steady temperature and greatest freedom from other 
vicissitudes, I would not hesitate to insure him, for a very 
slight premium, an attack of malarious fever. If he repeat 
the experiment a few times, his chance of escape would be 
annihilated. I appeal to my southern brethren whether I 
have stated the facts at all too strongly; the inferences to be 
drawn seem to me clear enough, that atmospheric alterna- 
tions are inadequate to the production of the familiar effects 
and that certain localities must possess some obscure but 
most efficient morbid agency. 

Lastly. The well-known modes of limitation of malarious 
diseases, to which I have slightly alluded, are apparently in- 
consistent with the action of "the obvious and patent, the 
plain and easily found" atmospheric influences dwelt on by 
Dr. Bell. For example: the city of Charleston; Savannah; 
the town of Beaufort; Aiken; the village of Walterborough; 
Edding's bay, on the sea shore; Sullivan's Island, in the 
estuary of Ashley and Cooper rivers, and Whitesville, with a 
thousand other safe summer residences, and "pine land set- 
8 



58 DICSSON ON MALARIA. 

tlements," as they are called, are known to be absolutely ex- 
empt, or nearly so — comparatively so in the highest expres- 
sible degree — from the endemical fevers which ravage our 
whole southern low country. Sleep within well-defined pre- 
cincts at each of the above named points, and you may in- 
dulge yourself with impunity in daily rides and walks in 
every direction around; venture to sleep out of the "charmed 
circle," and you will be assailed by periodical fever almost 
as certain as you will be vomited by ipecac, put to sleep by 
opium, or rendered insensible by ether. I cannot admit that 
the influences which thus act, or fail to act, are by any means 
"patent or obvious." Some of the points mentioned as 
healthy are remarkable for their atmospheric moisture; others 
for the impressive and agreeable contrast which they present 
in the refreshing coolness of their nights, after burning days 
of glare and sunshine. This is strikingly true of Sullivan's 
Island and Aiken; one of which is noted for a high, dry air, 
the other for a very damp atmosphere. Let any one compare 
them with the upper portion of New York island, climatically, 
and point out, if he can, in what atmospheric condition, ther- 
mometrical, barometrical, or hygrometric, consists the diffe- 
rence between them, which renders the latter so much better 
situated in so many respects, so much more liable, neverthe- 
less, to periodical, malarious, intermittent fevers. Nay, I 
think it would be difficult upon any "obvious" grounds, and 
setting aside the hypothesis of a specific poison, to explain 
the immunity of one end of Manhattan Island and one end 
of Sullivan's Island, and the alleged liability of the other end 
of each to this class of diseases. I have not laid any stress 
here upon the stones told of the liability of one side of a 
street or road, one side or one room of a house, nay, one 
side even of a ship, to these fevers, while the opposite side 
was free; nor upon the immunity of a ship's crew stationed 
a cable's length from the shore, while those who ventured 
after night on land were assailed; nor upon the occurrence 
of ague in the foetus; all which rests upon very fair authori- 
ty, and if true, are absolutely unaccountable upon any known 
or obvious mode of causation. The literature of mala- 
ria has been made almost as wonderful as that of mesmer- 
ism, and all who are sincerely anxious to arrive at the truth 
should be particularly careful upon what evidence they ad- 
mit such facts as the above, some of which are probably 
true, but ought to be more clearly made out and more 
strongly confirmed than they yet have been, 



DICKSON ON MALAEIA. 59 

3. The third argument for the specific nature of the cause 
of periodical fevers is drawn from the peculiar efficacy of the 
great specific cinchona. Like all other diseases, it is true, 
these present infinite diversities of grade and tenacity. Many 
cease spontaneously, many are easily arrested by any mode 
of interference and perturbation, bodily or mental, moral or 
physical. Fear, hope, joy, disgust, faith, on the one hand, on 
the other, venesection, the cold and hot baths, emetics, purga- 
tives, bitters, opiates, all cure intermittents. In some districts, 
whiskey is the great remedy; in others sage, the ancient 
panacea — " Cut moriatiir homo, cui salvia crescit in hortis" 
— is implicitly trusted to. Dogwood, logwood and spider's- 
web have their undoubting advocates. Remittents, however 
closely allied in cause and history, have been found much 
less manageable, and indeed, in some of their varieties, con- 
stitute very terrible forms of fever. What is most singular, 
however, is the fact that some of the worst of these, the most 
fatal in themselves, are most amenable to one particular 
remedy, and thus the mortality and obstinacy of the attacks 
are found to be, if not contrasted, at least not correlative. 
The true explanation of this apparent paradox seems to be, 
that ordinary remittents are apt to present certain complica- 
tions which modify their character so strongly as to remove 
them from the relevant adaptation of the specific above al- 
luded to — cinchona. Determinations to particular organs, 
highly irritative, inflammatory and quasi-inflammatory, are 
mingled with the febrile condition from the onset, which in- 
terfere with, control, or prevent the peculiar effects of the 
great febrifuge. Under these circumstances, in which, for 
whatever reason, the immediate administration of quinine is 
not followed with certainty by immediate benefit, as we 
know no other specific to substitute for it, we lose time of 
necessity, in efforts which differ among the several classes of 
practitioners, to remove, or palliate, or counteract these su- 
peradded local derangements, to which many attribute the 
continuousness or pertinacity of the paroxysm, and its ten- 
dency to throw off, or exhibit less and less clearly, the cha- 
racter of the periodicity originally belonging to it. If we 
succeed in these efforts, and procure an intermission or a 
marked remission, we put an end to the attack, without far- 
ther delay, by a dull dose of quinine. Nay, it has become 
the rule not to wait always for such change, but to experi- 
ment with the great remedy even in the most unpromising 
cases; and this is often done with the most gratifying success. 



60 DICKSON ON MALARIA. 

But no such preliminary management is necessary when the 
ease, however violent, is from the first, of merely congestive 
character. You need not here delay a moment. Cinchona 
alone is requisite, it is almost uniformly successful: in bad 
eases it is the only thing that offers any reasonable hope. — - 
So also in intermittents, pernicious, malignant, congestive, it 
is almost all-powerful. The first interval is enough-, if the 
first paroxysm is not fatal, your patient will probably reco- 
ver, provided you are well supplied with quinine and fear- 
less in its exhibition. There is no single point on which the 
medical profession, in all its divisions and subdivisions, is so 
fully agreed, as this. The worst cases, if simple and unmin- 
gled with complications, will yield to this remedy, and to 
nothing else. The mildest cases, in which its influence is 
disturbed or set aside, will prove obstinate, and may be fa- 
tal. The former are most purely febrile — we say malarious;, 
and we infer a certain relevancy or definite relation between 
the causative poison and its antidote or counter-agent. 

This relation or relevancy is farther shown, and very im- 
pressively too, by the influence of cinchona as a prophylac- 
tic. This influence is not exerted through the medium of 
any notable or observable effect upon the system, but most 
obscurely. There are other remedies known as prophylac- 
tic doubtless : alcohol perhaps, and if so, by its stimulant 
properly: tobacco perhaps, and if so, as a narcotic; opium ? 
perhaps, and in the same manner more efficiently; sulphur ? 
as is alleged, and if so, as a purgative and diaphoretic; tur- 
pentine, tar- water, and the like, and if so, by their diuretic 
action. But small doses of the sulphate of quinine, which, 
so far as is "patent and obvious," impress the organs and 
functions in no discernible manner, affecting neither the cir- 
culation, secretions, nor excretions, will enable the subject 
safely to undergo exposures otherwise fatal. 

It is curious to remark, too, that cinchona, which thus in- 
terrupts the progress of periodical or malarious fever, arrests 
it when forming, and even prevents its access, fails to act 
permanently upon the singular predisposition to recurrence 
which belong to its history. There is no disease so strongly 
disposed to return as this form of fever; yet no patient re- 
lapses while quininized, though many are attacked again as 
soon as quininism subsides. In other words, the influence of 
the febrific poison upon the constitution, though less forci- 
ble, is more tenacious and persisting than that of the anti- 
dote. Fortunately we are in possession of another remedy? 



DICtfSON ON MALARIA. 61 

in which these qualities are, so to speak, reversed. The ex- 
perience of the best European authorities, which coincides 
with my own, goes to prove that arsenic far more completely 
obviates the tendency to recurrence of protracted intermit- 
tent than quinine, while it is infinitely less efficient and use- 
ful in the management of the disease when present. 

The facts, then, which, at the risk of some repetition, I 
have thus brought together, will, I think, if carefully con- 
sidered, be found abundantly to establish the position that 
the cause of periodical fever is a specific poison : — 

Its influences or modes of development are peculiar and 
characteristic : 

Its phenomena are not explicable by reference to the 
agency of any known causes ; 

It is controlled only by the obscure, undefined and unin- 
telligible action of specific remedies. 

The next step in our discussion leads us to investigate the 
nature of this specific poison — to inquire whether it is or- 
ganic or inorganic; animalcular or of vegetable growth; an 
effluvium or a gas. 

The received hypothesis of the existence of any such 
agent, whichsoever of the above suppositions we may adopt, 
is full of difficulty, it must be admitted. The embarrass- 
ments which hang about it are dwelt on and well displayed 
by several recent writers, at the head of whom stands Dr. 
Bell, of Philadelphia, already frequently spoken of in terms 
of cordial and well deserved respect. It remains to be seen 
whether any substituted hypothesis is more explanatory, 
freer from difficulties, or better entitled to our belief. 

The views of Dr. Bell, like those of Prof. Dunglison, are 
rather negative than positive; they express dissatisfaction 
with the current opinions, whether, as laid down by Lan- 
cisi, or Macculloch, or Ferguson, but propose nothing defi- 
nite in their stead. The position taken by the first named 
author since 1825, is maintained (in 1849) by Dr. Gayles, in 
a very instructive essay in the American Medical Journal 
for January, carrying out the argument in minute detail, and 
collating with great industry a large mass of valuable facts, i 

In 1828, Dr. Jones, of Georgia, reproduced in terms the 
ancient theory — "that moisture under different states of 
temperature, acting upon the human frame under different 
states of the cutaneous functions and muscular relaxation, is 
to be regarded as the sole cause of intermittent and remit- 
tent bilious fevers." This axiom is definite enough and 



62 DiUKSON ON 3IALAK1A. 

comprises all the points labored by the writers above men- 
tioned. It is easy to show that it is overlaid and encumber- 
ed with objections quite as great as those which it is offered 
for the purpose of evading. The low alluvial lands of Lou- 
isiana, free, according to Nott, from these fevers; and her 
bayous, remarkable, according to Cartwright, for their salu- 
brity, abound in moisture. The same assertions are made 
concerning the extensive tracts now under drainage by the 
State in Hyde county, North Carolina, and the great Dismal 
Swamp. In the vast extent of country included within 
these limits, moisture must surely have an opportunity of 
acting upon the human frame under all different conditions 
imaginable. If then, these fevers are not numerous and ve- 
hement there, something else is wanting to their production. 

Equally untenable is the contrasted doctrine advocated by 
Ferguson, — that "paucity of water where it has recently 
abandoned is the only contingency necessary in a warm 
climate, to the production of malarious fevers or their cause." 
In Africa, as travellers inform us, the very termination of the 
dry season, the very commencement of the rains is the pre- 
cise period at which fevers begin their sway; the influence 
of the abundant moisture descending through the hot air 
being felt, as we are told, at once, or in an almost incredibly 
short time. In our own country it would be idle to speak 
of paucity of water, either absolute or comparative, in refer- 
ence to our inexhaustible lakes, ponds and inland swamps, 
in the neighborhood of which malarious fevers annually 
prevail. 

Of the electrical causation of these fevers suggested by 
Murray and others, and the modification proposed by Fol- 
chi, usually alluded to as the thermo-electrical theory, in 
which the whole train of phenomena are ascribed to the 
combined influences of abnormal calorification and disturbed 
electrical equilibrium, I shall only say that they are present- 
ed to us in too vague and indefinite a shape to justify our 
admission of them. The vast proportion of the earth's sur- 
face affected ; the great diversity of soil, climate, weather 
and indeed all atmospheric contingencies with which the 
presence of these fevers is associated, preclude the possibili- 
ty, it would seem, of any similar thermal or electrical states, 
either of the air or of the bodies of those attacked. Yet the 
facts accumulated in support of these views are interesting^ 
and may be destined to assume a greater degree of impor- 
tance in the future discussions of the subject than we can 
venture to accord to them now. 



DICKSON ON MALARIA. 63 

The gaseous nature of the cause of periodical fevers has 
been ably maintained by Professors Gardner and Daniel, 
who consider it to be sulphuretted hydrogen. In a very in- 
genious thesis, recently presented to the New York Univer- 
sity by Dr. Leavenworth, the claims of carbonic acid are 
strongly set forth: and several of our western brethren are 
satisfied that the evil agent is nothing but carburetted hy- 
drogen. Not to enter minutely into the controversy, I will 
merely state that an insurmountable difficulty in the way of 
either of these suppositions lies in the great variety of local- 
ities and circumstances geographical and geological in which 
we meet with the effects of the alleged cause. We find 
these fevers on the cold fens of Holland and Lincolnshire, as 
well as the rich rice fields of the sunny south; on the smiling 
hills which overlook the majestic Hudson, as well as among 
swamps and marshes; on the lime rock of Tennessee and 
Kentucky, the clay of Alabama and South Carolina, the 
sandy barrens of her northern sister, and the granite and 
sienite of the Empire State ; on the volcanic tufa of Civita 
Castellana and the Roman Campagna, and in the very cra- 
ter and on the sides of extinct volcanos, as at Bolsena and 
Milo. If sulphuretted hydrogen be eliminated in an African 
jungle or on the borders of a sluggish creek in Virginia, 
whence does it arise in some of the contrasted localities so 
often enumerated? Why is not fever, on one hypothesis 
always endemic at the White Sulphur and Sharon Springs; 
and on the other at Saratoga, Seltzer and Vichy? Why is 
not the presence of some of these gases always demonstrable 
in a malarious atmosphere? Having ascertained the poison, 
why cannot we at will produce with it an attack of fever of 
one of the known types — in other words, how is it that the 
observed morbid effects of none of the irrespirable gases re- 
semble any known form of fever? 

We are encouraged in our search after atmospheric in- 
fluences as causes of disease since the discovery of ozone by 
Berzelius, and the observation on the part of Schoenlein, of 
its presence in the air during the epidemic prevalence of in- 
fluenza. Of this widely-extended and most familiar malady 
it really seems to be one of the efficient sources. In this 
country too some of our professors have ascribed to it, has- 
tily I apprehend, the generation of cholera. If this active 
state of the atmospheric oxygen does not really produce in- 
fluenza, we must not omit to remark its relation to that 
well-characterized intermittent affection of the frontal sinus 



64 DICKSON ON MALARIA. 

and antrum, of which I spoke above, and which is of so 
frequent occurrence, so painful and annoying, and so obsti- 
nate that I wonder at its having received so little attention 
from medical writers. Some I think allude to it vaguely as 
"a masked intermittent" classing it with neuralgias; others 
have probably referred to it under the title of "brow ague." 
I have found it, though not readily yielding to any remedies, 
yet on the whole, best palliated and controlled by the free 
use of the sulphate of quinine. 

The following objection seems to me fatal to all the above 
hypotheses of causation equally and alike, unless when they 
admit of being resolved into the familiar belief of a specific 
poison, paludal, or fungous or animalcular. All patent and 
obvious agencies "must produce, logically, patent and ob- 
vious effects. " Changes of temperature must make notable 
impressions on the system, irrespirable gases cannot be 
breathed without notable inconvenience or derangement of 
system. But when a poison is applied, it is absorbed and 
retained, and passing into the organism, finds in due time a 
reception upon the tissues, or within the fluids it is adapted to 
affect, if inorganic. If organic, a single dose may be large 
enough to be promptly efficient, but more generally an inter- 
val is required for its increase, propagation and multiplication. 
These are principles upon which I need not dwell. Let a 
subject visit on a pleasant summer evening a field in our 
southern low or middle country, especially in the neighbor- 
hood of a rice-reserve or a stream, and sleep there; or let him 
rest under a tent in the desolate plain near the ruined temples 
of Psestium; he may rise the next morning in undisturbed 
health, and continue perfectly well for a fortnight or three 
weeks, and then without warning, fall suddenly a victim to 
an overwhelming attack of fever, congestive or inflammato- 
ry. To render this mystery, if possible, still more mysteri- 
ous, and laugh to scorn all attempts at explanation by an 
imagined accumulation of carbon in the system, a gradually 
augmenting determination to or congestion in the portal ves- 
sels, the vena cava, the vessels of the spleen, of the cerebro- 
spinal axis, or of any other organ or tissue, let such a sub- 
ject, a few hours previous to the explosion of the febrile 
symptoms, take two or three full doses of cinchona or qui- 
nine, bringing on some fulness of the head, some buzzing in 
the ears or dimness of vision, and he will — with as much 
certainty as any thing established in therapeutics — escape 
the threatened attack; or avert a second if he has been sur- 



DICKSON ON MALARIA. 65 

prised by a first, and favored with an intermission. But 
the counter-poison here employed is not known to eliminate 
or discharge anything from the body by an outlet; we can- 
not affirm that it promotes the excretion of retained or accu- 
mulated carbon, hydrogen or nitrogen, through either the 
lungs, the liver, the kidneys or the skin; and yet it is a re- 
medy infinitely more available than the most active evacu- 
ants or so-called depuratives. Nor is it easy to conceive 
how it corrects the morbid impressions made upon the organ* 
ism, either thermally or electrically; its influence seems 
purely antidotal, and implies the previous presence of a de- 
finite poison. 

We have increased gratuitously the obscurity of our present 
inquiry by the universal habit of ascribing too much to the 
agency of a cause whose very existence is matter of inference, 
however rational and logical that inference may be, and its 
alleged source and nature altogether hypothetical. Fergu- 
son and Bancroft, and many others, Trevin among them, 
confound yellow fever with malarious diseases; Cook places 
typhus here also; and some Western writers have not hesi- 
tated to include cholera asphyxia in the same category. The 
ridiculous extension of the list in Macculloch needs no com- 
ment; but I will content myself with stating my belief that 
we have no right in this controversy to refer to any other 
morbid affections than intermittent and remittent fevers, in 
which periodicity is the prominent element, and in which the 
observance of regular type and period can be clearly traced, 
calculated and predicted. Even hepatitis, dysentery and 
dropsy, so familiarly comprised under this head, should, in 
proper strictness, be rejected as at least doubtful; nay, as in 
all probability, the secondary effects of malarious fevers, or 
the result of coincident contingencies. It is but a single sum- 
mer since an epidemic dysentery of great virulence and large 
proportional mortality prevailed over a vast extent of terri- 
tory, from the Lakes and the St. Lawrence to the Atlantic 
coast; from the Merrimack to the James river; affecting ma- 
ny districts celebrated for their usual heath fulness, and espe- 
cially portions of New-England, hitherto free from the sus- 
picion of malarious impurity, and unconscious of intermit- 
tent fever since the incursion of the Pilgrim Fathers. If we 
ascribe this disease to malaria on the banks of the Delaware 
and the Potomac, what shall we say gave rise to it along 
the rocky shore of Connecticut, or on the cold and barren- 
soil of the interior of Hhode Island? 



€tf DICKSON ON MALARIA. 

The strength of the argument in favor of the organic na* 
ture of malaria lies in the history of the latent and intercur- 
rent periods of the fever which it produces. It is easy to 
show the failure of the received views to explain these phe- 
nomena; indeed all pathological writers feel and acknow- 
ledge frankly this defect. Now, if we suppose with Prof. 
(J. K.) Mitchell, an organized germ of vegetable character 
introduced, qua data porta, into the system, we may well 
imagine that its growth and multiplication will require a 
Certain progress of time, during which its reproduction will 
augment the quantity of deleterious matter into an efficient 
dose. Thus we account for the incubation of the attack. — 
We further imagine then, either the death of the first gene- 
ration of fungi, or the elimination of the great mass of them 
through some of the emunctories, to explain the interval of 
intermission; and the birth and development of successive 
generations to render intelligible the long train of tenacious- 
ly recurring paroxysms. We imagine too that the several 
types of intermittent are owing to the variety of forms of 
cryptogamous vegetation, some of which propagate in one 
period and some in another. This hypothesis is indeed most 
ingeniously conceived and ably maintained; it is supported 
by a large mass of facts, to which accumulations are almost 
daily making and will apply, as stated above, to a great por- 
tion of the history of malarious fever. But it does not en- 
tirely escape or surmount all the difficulties of the subject — 
nay, some remain, which threaten to be fatal to it, notwith- 
standing all the genius and learning which its author brings 
to its support. Thus, for example, the relations of malaria 
—be it what it may — are strongly, and as regards its gene- 
ration and production, exclusively to place. But it is just as 
tenacious in its adhesion to the person of its subject; it seizes 
upon him often after very brief exposure ; it enjoys within 
the animal or rather exclusively the human organism a con- 
genial habitat where it finds all the material of growth and re- 
production, and from which it is dislodged with great diffi- 
culty. Except in this relation to person, it is not transfera- 
ble; it is never transported by any known mode, any varie- 
ty of fomites, nor when produced in one patient does it affect 
another by any closeness of propinquity. But if propagated 
within the body, tenacious of life as it is, how can it fail to 
pass out through some of the emunctories into the air sur- 
rounding it; and if diffused therein, how can it fail to attack 
a subject just as readily as when propagated or created out 



DICKSON ON MALARIA. 67 

of the body? This never happens, however, and if it did 
happen, would be contagion or something closely analogous. 

Again, the books are full of wonderful stories of the fixity 
of malaria on certain occasions, though at other times easily 
wafted on the wings of the lightest zephyr. We read of one 
side of a road, a street, a house, a ship, being sickly while 
the opposite is quite free from fever. These interesting 
curiosities of malarious literature are as well attested as other 
wonders of nature, but as I have already said, require ex- 
amination and confirmation; at any rate, every one is aware 
of the apparently capricious action of the cause of periodical 
fevers, whatever that cause may be. The received theory 
is the butt of much sarcastic criticism in reference to this 
matter; but it does not seem to me to enjoy by right a mo- 
nopoly of the taunts lavished on our ignorance of the details 
necessary to a clear and full understanding of this grave to- 
pic. If malaria be fungous, it must either be breathed or 
swallowed, absorbed by the pulmonary or gastro-enteric 
mucous membrane, or by the cutaneous surface; for all this, 
it must be diffused in the air. When thus diffused, why does 
it not cross a road or street, or piece of water, invading a 
ship "a cable's length from the shore," or spread throughout 
a house, a vessel's hold or cabin? Odors and dust are thus 
spread; smoke and vapors disperse themselves; gases per- 
meate each other; why should not fungi, smaller than some 
of these particles, larger than others, obey the movement of 
currents of air in which they are floating ? 

If, with Dr. Nott, of Mobile, we adopt the animalcular 
nature of malaria as its most probable modus extendi, we are 
hedged in by the same difficulties. The supposed animalculi 
are no less capricious in their voluntary movements than the 
inorganic effluvia of Macculloch and Bancroft. Generated 
in a given spot, they leave it readily to attack an individual; 
but when abounding in the body of one person they will not 
leave it to assail another. They show similar caprice of 
resolution occasionally in adhering to fixed positions men- 
tioned above. 

Dr. Nott recognizes and points out the marked difference 
in many points between yellow fever and malarious remit- 
tents and intermittents, the former of which is clearly sepa- 
rated by cause, history, symptoms and effects, from all the 
periodical fevers. He renders highly probable the animal- 
cular — he proves the organic origin of yellow fever. It is 
transportable in atmosphere, and in fomites. It is transfer? 



68 JARROT ON SULPHATE OF IRON IN CHLOROSIS. 

able not only from place to person like malaria, but from 
place to place and from person to person. It is strongly con- 
trasted with malarious fevers by exhausting the liability to 
its recurrence; in this respect resembling other known con- 
tagions. Yet it is hard to understand why it should adhere 
exclusively to one side of a ship, or why, when it does make 
progress, this should occasionally be so slow and seemingly 
reluctant. In towns it extends its domain, sometimes quick- 
ly, sometimes otherwise; going "like the tax-collector from 
house to house," and thus gradually widening a the infected 
district." We may, it is plain, refer here to the independent 
volition, the action from inclination of creatures capable of 
choice, an explanation denied us as to a fungus or an inor- 
ganic effluvium. But we must take for granted prodigious 
strength of wing proportionally in these minute creatures to 
enable them, if they rise at all in the air, to resist the move- 
ment of a breeze or strong current. 

It is by no means my purpose here to go over the trite 
ground of a defence of the views of malaria, which, with a 
large body of the profession I have received, and with which 
every reader must be familiar. My object has been merely 
to collate and compare the several hypotheses that have been 
offered; to show that none of them are free from intrinsic 
difficulties; none of them fully explanatory; none of them 
entirely satisfactory. I conclude with the suggestion that 
the word malaria may still be very conveniently and proper- 
ly retained to denote an unknown cause to which we ascribe 
certain effects, which as yet are not proved to be the result 
of any discovered or obvious agency. — N. Y. Jour, of Med. 



On the Sulphate of Iron in Chlorosis. By Richard Jar- 
rot, M. D., of Quincy, Florida. 

Chlorosis is a form of disease so common as to be recog- 
nised even by the unprofessional, by whom its subjects are 
often unjustly stigmatised as dirt or trash-eaters. Perhaps 
there is not a practitioner in the United States, who is not in 
the habit of treating it frequently. It is to be found in eve- 
ry latitude and locality, and hence, although isolated cases 
do not attract much notice, yet when we reflect on its uni- 
versal prevalence, we shall be convinced that it forms a con- 
siderable item in the general mass of human suffering. It 
is common to both sexes, though a majority of such patients 
are girls just about or anterior to the age of puberty. 



JARR0T ON SULPHATE OF IRON IN CHLOROSIS. 69 

The bloated and cadaverous aspect, the dull and dejected 
countenance, expressive of suffering, the difficult breathing, 
the slow movements, the agitation above the clavicles on 
the sides of the neck from vehement action of the carotids, 
with serous effusion about the ancles, are its distinguished 
characteristics. 

In males between the ages of 25 and 30 chronic ulcers of 
the legs, are frequently to be found, and 1 am persuaded that 
I can distinguish these subjects on sight. 

In young girls whose menstruation is irregular, or with 
whom that function is not established, there is foul breath and 
tumid abdomen. Moreover, there is superadded hysterical, 
and other paroxysms incident to the female organism. Now, 
it is just in such cases as are described above, that the sul- 
phate of iron is an invaluable remedy. I am not much of a 
believer in specifics, but I do not hesitate to affirm, after 
much experience, that in Chlorosis, not associated with or- 
ganic disease, it is a specific. Judiciously, and in proper 
time administered, it will certainly arrest that morbid state 
or condition which left uncontrolled runs rapidly to fatal dis- 
organization. Of all the lesions which are developed in the 
progress of the malady, those of the heart are most serious. 
"Its most common sounds are similar to those emitted after 
copious hemorrhages, and therefore denoting or coinciding 
with enfeebled circulation." Where there are dropsical ac- 
cumulations and difficult breathing we may suspect disease 
of this organ. Should they persist in the spite of remedies, 
an examination will be apt to detect the morbid sounds 
diagnostic of hypertrophy, and thus suspicion will be con- 
verted into certainty. Local and general dropsy now ensue, 
which is only temporarily relieved by digitalis and other 
anti-hydropics. 

Whatever may be the cause of Chlorosis, doubtless an im- 
poverished state of the blood is one of its essential conditions. 
And this results directly from a scanty and innutritions diet. 
This view is confirmed by the fact that a large majority of 
patients of this description belong to the poorer and more 
improvident classes. A diet of bread and milk will bring 
on a weakly habit of body, and in the end, if persisted in, 
Chlorosis. The absence of salt in the food also predisposes 
to the disease. Dirt eating is looked upon by superficial ob- 
servers as the cause of Chlorosis, but the truth is, it is a mor- 
bid craving, owing to the want of a wholesome and proper- 
ly seasoned food. It is a mere incident, or symptom, and 



70 JARROT ON SULPHATE OF IRON IN CHLOROSIS. 

not a cause. Iron in some form is known to every practi- 
tioner to be adapted to simple Chlorosis, but the sulphate in 
my hands has proven to be by far the best preparation of 
this metal. My common practice is to combine it with aloes 
and myrrh, though the latter article is not indispensable. It 
will generally be found that great torpor prevails of the 
whole mucous surface of the intestinal tube, and that the 
lower bowels are distended, sometimes to their greatest ca- 
pacity with the various secretions within their cavity. Part 
of this returns to the circulation where it produces well 
known effects. It is obvious, therefore, that the bowels 
should be operated upon before resorting to the tonic. An 
excellent combination for this purpose is calomel, rhubarb 
and aloes. It should be repeated day after day, until tho- 
rough evacuations are procured and the stools become natu- 
ral. This being effected, a pill of one grain of each sulphas 
ferri, aloes and myrrh is to be given thrice daily, morning, 
noon and bed-time. Twice a week, at bed-time, some blue 
mass, or other mercurial is to be substituted for the tonic 
pill. In ordinary cases this treatment will suffice, and it 
should .be prolonged for an indefinite period, or until health 
is restored. The quantity of the sulphate in each pill should 
be lessened or increased, according to the capacity of the 
system to bear it. Sometimes nausea, griping pains and 
other unpleasant effects follow its use, in which event the 
quantity should be lessened or the wine mixture mentioned 
below, used in its place. I have given as much as ten grains 
daily, or three and one-third grains to each pill. In general, 
two grains to each pill may be considered as the average 
quantity adapted to ordinary cases. The copperas should 
be burnt before it is made up into pill, and this can be very 
conveniently done, with the aloes and myrrh by means of 
the extract of gentian. A neat formula for the exhibition of 
the iron is the following: — Port Wine, 1 qt., tinct. Aloes, 
iv. 5. tinct. of Myrrh, ij5. Dose a table-spoonful thrice dai- 
ly, with the mercurial twice during the week as above di- 
rected. I have prescribed this formula in some cases of sup- 
pressed menstruation with the happiest effects. The addi- 
tion of a scruple, or two of the sulphate of quinine where 
there are periodic indications, will be found a valuable aux- 
iliary. In whatever way the sulphate may be used, whe- 
ther in pill or solution the beneficial effects of the treatment 
soon appear. The secretions are restored and invigorated, 
especially that of the liver, whence there is a constant drain 



JARR0T ON SULPHATE OF IRON IN CHLOROSIS. 71 

from the aloetic impression. The swellings, if there are any, 
disappear, the dyspnoea is relieved, the movements become 
active, and the sickly complexion gives place to a healthy 
glow. The countenance brightens and becomes cheerful 
and intelligent. The muscular system resumes its firm feel- 
ing and activity. In short there is a restoration to health. 

Suppressed catamenia is a troublesome complication of 
chlorosis, and it greatly aggravates and renders more re- 
fractory the existing symptoms. Leucorrhoea often super- 
venes, and the discharge increasing at every recurring peri- 
od, the gravity of the case is thus materially augmented. — 
As is to be anticipated on these occasions, hysterical parox- 
ysms are to be witnessed in all their various phases — fugi- 
tive pains, or those of a fixed or intermitting character now 
assail the irritable body. The temporal, intercostal, cardiac 
and lumbar regions are especial seats of suffering. The 
pulse becomes preternaturally frequent and there are well 
marked febrile exacerbations. The whole process of diges- 
tion is deranged, and there is morbid craving for alkalies. — 
The mind, yielding to the pressure of disease, becomes cheer- 
less and dejected. I do not notice the minor symptoms. 
They stand forth in gloomy array, rendering the subject of 
this afflicting malady an object of distressing contemplation 
to her friends and of hopeless despondency to herself. Such 
is a rapid sketch of the disease as it has presented itself to 
my observation in females. In order to avoid embarrassment 
as to tonic and alterative remedies, and to give them free 
scope for action, it is essential that a judicious preliminary 
treatment should be employed. At the risk of being tire- 
some, I must here repeat my conviction of the great necessi- 
ty for purgatives. They are very decidedly indicated, and 
they should be administered with a liberal hand. As was 
before intimated, mercurials should enter largely into what- 
ever combination is employed. Equal parts by weight of 
calomel, aloes and rhei, in sufficient quantity to act briskly, 
will answer very well, and it should be given at bed time 
and followed next morning by oleum ricini and spirits tere- 
binth, or sulphas magnes in an infusion of senna. Purga- 
tion should be kept up until the secretions become natural, 
and the abdominal walls are relaxed and yielding. Under 
such circumstances the quantity of mucous, bilious and 
faecal matter discharged from the bowels is enormous, and 
the relief is signal. The warm bath is an admirable and ef- 
fective auxiliary, and it should be resorted to daily, the 



*72 JARR0T ON SULPHATE OP IRON IN CHLOROSIS, 

whole body being immersed and suffered to remain until the 
blood is diverted to the surface. The patient is now ready 
for the iron pill, and it should be given agreeably to the di- 
rections, increasing the quantity of the salt as the system 
will bear it. This treatment, in conjunction with out door 
exercise and a generous diet, will rarely fail to effect a re- 
storation to health. A glass of good Madeira wine, in the 
absence of special contra-indications, will act in unison with 
the tonic. It has already been stated that from individual 
idiosyncrasy various ill effects have resulted from the pill, 
which has thereby rendered it inadmissible. In this contin- 
gency the wine mixture may be resorted to, and where sti- 
mulants are indicated in the case this formula should be se- 
lected from choice. In either case it is important that the 
mercurial treatment should not be neglected. With regard 
to the pains mentioned above, I have not found any special 
treatment necessary. They vanish, as all the symptoms do, 
under the iron treatment. As, however, they form, on the 
part of the patient, the subject of serious complaint, it may 
not be amiss to allude briefly to them in this place. In the 
beginning of my practice allured by the very flattering ac- 
counts of the miraculous cures by counter irritation, of a host 
of morbid sensations ascribed to spinal irritation, with which 
it was the fashion of the periodicals to favor the profession, 
I became a diligent manipulator of the spinal column. No 
sooner was the tender spot made or discovered than down 
went the scarificator, the mustard or the blister. But suc- 
cess by no means equalled my expectations, and I was led 
finally to conclude, that the cures so called, and which were 
exhibited in such glowing terms, were achieved solely 
through the medium of the imagination. I regard the pains of 
chlorotic patients as purely sympathetic, depending on func- 
tional derangement of the organs, and especially of the sto- 
mach and uterus. These being restored to their normal condi- 
tion, the morbid associations radiating from them necessarily 
come to an end. No allusion is now made to such as are con- 
nected with organic disease. Where it is desirable to treat them 
specially, a writer in a back number of the Medico-Chirurgical 
Review, in an article on Chlorotic fever recommends emetics 
of ipecac. Where these fail a small blister is to be applied to 
the spot, and after the removal of the cuticle half a grain of 
morphine is to be sprinkled on the denuded surface. This, the 
writer affirms, to be a specific. The treatment is doubtless 
applicable, and in obstinate cases should be tried; but in my 



JARR0T ON SULPHATE OF IRON IN CHLOROSIS. 73 

own practice I have never found it necessary to adopt it. — - 
It has already been remarked, that where dropsical accu- 
mulations prove obstinate there is reason to suspect incipient 
disease of the heart, and that this forms the most serious 
complication of Chlorosis. In the end indeed it proves to 
be the principal malady. Enlargement -of the heart is sure 
to be followed by effusion within the pericardium. Ascites 
and anasarca follow in rapid succession. Although in this 
stage all treatment is unavailing as regards its ultimate ter- 
mination, yet life may be prolonged, and by judicious ma- 
nagement, even rendered tolerable. It does not follow that 
because the heart is involved, the case is to be abandoned) 
much less those where it is not positively certain. For 
Watson affirms that some of the sounds regarded as diag- 
nostic of organic disease may be present, and yet the patient 
may recover under tonic treatment. I have alternated the 
depletory with the tonic plan in such cases with decided ad- 
vantage to the patient. In my hands the following prescrip- 
tion has been of signal service to subjects laboring under 
such lesions: bi. tart, potass, nitris potass, cinchona aaj 5, sul- 
phate iron, ss§, whiskey or gin, oij. To be mixed and well 
shaken up. Dose from one to six teaspoonsfull daily. — ■ 
Where the dropsy is independent of a diseased heart, the 
case is under the control of remedies. In order to expel the 
effusion every practitioner has his own mode. My own is 
to operate through the bowels. For this purpose I have 
found the following to be successful: aloes socot, xxiv gi\, 
proto-chlor. hydr., xxxxviii gr., antim. tart, ij gr., rad scillae, 
xxiv gr. To be made into 24 pills. Where the habit is cold 
and sluggish a grain or two of Cayenne pepper to each pill, 
enhances its efficacy. At bed-time from 2 to 6 of these pills 
are to be given to be followed next day by bitartrate of 
potash and jalap until free serous evacuations were pro- 
duced. The infiltrated tissues soon sink to their natural di- 
mensions, and now the iron pill is to be used. Should there 
be a recurrence of the swellings the same practice is to be 
repeated, which is to follow up by the tonic. I speak from 
actual experience when I say that this treatment will never 
fail, it being understood that no reference is made to cases 
which have advanced a change of structure. 

It is of importance that the diet should be generous. It 

cannot be too rich provided it be digested. That the blood 

is greatly impoverished, is manifest from the superabundance 

of serum and the comparative absence of the crassamentum, 

10 



74 JfARROT ON SULPHATE OF IRON IN CHLOROSIS, 

and it requires a nutritious diet to furnish the elements of 
healthy blood. To maintain the animal heat, warm and 
comfortable clothing is indicated, and to give activity to the 
various secretions regular exercise is to be enjoined. Among 
the black population of the South there are numerous sub- 
jects to whom the administration of the iron pill would be an 
invaluable blessing. It would be tedious to describe such 
cases minutely. In general they are advanced in life, the 
bowels are habitually confined, there is headache, suffused 
and jaundiced eyes, slow movements, sometimes palpitations 
and a pale complexion, as if the patient had been secluded 
from solar light. To use their own expression? they are 
neither sick nor well. In all such cases the pill acts like a 
charm, and the improvement arising from its use is striking 
and signal. I am no enthusiast in regard to remedies, and I 
have not the exalted opinion of their potency that I once en- 
tertained, but I should think it difficult to exaggerate the 
merits of the sulphate of iron in chlorosis. It laid on my 
shelf for years before I used it, and at length it was by 
chance only that I was induced to employ it. The young 
practitioner in his search for tonics is too apt to select such 
alone as produce an immediate impression, and to overlook 
this humble but really potent article of the materia medica. 
It would be presumption in me to suppose that there is any 
thing contained in this paper with which the elder members 
of the profession are not perfectly familiar. I have endea- 
vored to state clearly some practical details, and these I con- 
ceive to be of greater interest and value by far than the most 
learned disquisition. In the disease described above, in 
whatever guise it may appear, the sulphas ferri is undoubt- 
edly the best of all the ferruginous preparations. And it seems 
to have a most happy effect associated with aloes. The 
combination is one of those happy hits which it is the good 
fortune of the practitioner occasionally to meet in medicine. 
Iron is the remedy par excellence in chlorosis, but I am not 
aware that it is recommended in the books in the manner 
advised in this paper. — Charleston MedicalJoumaL 



POINT OP A KNIFE IN THE BACK NINE YEARS. 75 

Point of a Sheath-Knife in the Back Nine Years — Remo- 
val. By George H. Gay, M. D. 

In May, 1840, Capt. ,the subject of this operation, 

was walking quietly along deck with his hands in his pock- 
ets, when he felt a sudden and cutting blow on his left 
shoulder. He turned round immediately, and saw one of 
his crew, a Manilla man, flourishing his sheath-knife, co- 
vered with blood. A long and hard scuffling took place 
before the man was secured. A short time afterwards, the 
knife was found with quite a piece of the point broken off. 
The captain did not know, at the time, whether this piece 
was broken off in his shoulder, or during the scuffling; 
though shortly after, the "idea possessed him" that the point 
was in him. 

The wound was not very painful nor troublesome; there 
was no feeling of any foreign substance present, it discharg- 
ed matter freely, and was entirely closed in three weeks af- 
ter the assault. The cicatrix looked firm, entire and heal- 
thy, about two and a half inches in length. The shoulder 
afterwards felt well, though there was an occasional dull, 
indistinct pain in the region of injury, but never sharp nor 
pricking. The motions of the arm and body were free from 
any uneasy feeling. 

In the following February, patient slipped and fell down 
the companionway stairs, hitting his left shoulder against 
each successive step. Almost immediately, there was great 
swelling of shoulder, with acute pain. The swelling in- 
creased so much that he "thought it would break." Arriv- 
ing at Singapore, ten days after the fall, he was examined 
by a surgeon. A free incision was made in swelling, and a 
large quantity of healthy-looking matter was discharged. It 
was then probed, but no foreign substance detected. 

From that time, with the exception of three or four days, 
to the 16th May, 1849 (when he consulted me), there has 
remained an opening, communicating with a sinus, with 
greater or less discharge, according to circumstances. Dur- 
ing these three or four days, the opening was closed, and it 
was exceedingly painful, "till it broke." He has consulted 
many surgeons here and abroad, and always asked if the 
piece of knife could be there. They all said no, probably 
because the probe never struck upon it, and such a length 
of time had elapsed since injury. Every variety of treat- 
ment has been recommended and adopted, of which strong 



76 POINT OF A KNIFE IN THE BACK NINE YEARS. 

injections of nit. argent., tinct. iodine, and bandaging and 
setons were among the most prominent. 

A long sinus remained on the 16th of May, when he con- 
sulted me. The appearance of the parts was the following: 
— Redness of the skin, with thickening of it and subjacent 
tissues, below spine of scapula; about two inches below 
commencement of acromial process, there were some pale ? 
flabby, elevated granulations, in the centre of which was an 
opening, the size of a pea, admitting easily a common direc- 
tor, which passed Jive inches obliquely downward along 
scapula, and came out of an opening made by seton; no ten- 
derness, on pressure, in any part of it. At this time, as 
nothing had been said to me about the knife being broken, 
merely saying that he had been stabbed, my attention was 
directed chiefly to detect some necrosed portion of the scapu- 
la, a piece of dead bone being considered sufficient to keep 
open the sinus. But nothing of the kind was found, nothing 
but a long sinus. 

The sinus was freely laid open about five inches. No ne- 
crosed bone nor foreign substance was touched. The probe 
was passed along inferior surface of wound, but could not 
be insinuated into any other opening. The wound was 
soon filled up with healthy granulations, and the whole ci- 
catrized, except a small spot at the most dependent part of 
the wound, where, after a while, pus was discharged, by 
pressure from below upwards. 

The 6th of August, when he came to me again, there was 
a flabby, pale, nipple-like projection, in the above mentioned 
spot, with an opening. Introducing the probe, another sinus 
was found, Jive inches long, going nearly vertically down- 
wards. I told patient this also must be laid open. Dr. 
Hayward, who saw patient at my office, was of the same 
opinion. 

August 9th, in presence of Dr. Hayward, the sinus was 
laid open to the extent of Jive inches. No foreign substance 
was felt along track of incision. Passing finger along the 
lower portion, it entered, quite easily at first, still another 
sinus, going nearly at right angles to it. The probe intro- 
duced here, touched some foreign substance. It could not 
be hit, or rather Jelt, every time. The feel was rather pe- 
culiar; at one time rough, and at another smooth, and ex- 
tremely difficult to distinguish from the smooth, hard lining 
membrane of sinus. It was determined to lay this open, 
which was clone to the extent of over Jour inches. Patient 



POINT OF A KNIFE IN THE BACK NINE YEARS. 77 

said it felt so sore that no farther examination should be 
made then. A compress dipped in cold water, with band- 
age, was applied, and he went home. 

The next morning, while dressing and examining wound, 
some sharp substance pricked my finger. Introducing a pair 
of forceps in a small cavity, on each side of the most depen- 
dent part of incision, the piece of knife was extracted, an 
inch long and ivide, black, with the point rough and bent 
(probably from the blow on the scapula), and Jifteen inches 
or 'more from the original seat of injury. This would have 
been found, the day of the operation, if he had not been 
"too sore" to examine. The smoth,nat surface of the knife 
lay upon muscle, parallel with the direction of the sinus. 

This case is interesting, and somewhat remarkable, from 
the fact — 1st, that the wound was entirely closed in three 
weeks after injury, and remained so for nine months, till the 
fall down the "companionway." 2d, that patient had expe- 
rienced so little suffering from such a sharp-pointed, trian- 
gular-shaped substance. One would have supposed that the 
varied motions of the body would, at times, bring one or 
more of the points in such a position as to produce a prick- 
ing sensation. 3d, that it remained nine years, without any 
sensible alteration in size. (Would it have remained so un- 
altered, if it had been in the stomach ?) We know that lead 
frequently remains a long time in the body; that a new 
membrane forms around it, on which the lead does not act, 
and which, at the same time, protects the surrounding parts 
from being injured. Weight, position and shape are the 
most powerful causes for the travelling about of substances; 
if round or rough and heavy, its tendency will be in a down- 
ward direction, modified by the position and motions of the 
body; if sharp and light, the motions of the body place it in 
this or that course, the very sharpness of the point or points 
preventing any new membrane from keeping it in one 
place, as in the case of needles. 4th, that the feel of a fo- 
reign substance was not constantly given to the probe, but 
only when it touched the rough part of the knife; the coat- 
ing, so to speak, of pus upon the smooth surface rendered it 
difficult and almost impossible to say when the probe touch- 
ed the hard membrane of sinus, and when the smooth sur- 
face of the knife, the feel of both was so much alike. — Bos* 
ton Medical and Surgical Journal. 



78 LEMON-JUICE IN RHEUMATISM AND DYSMENORRHEA. 

Lemon-Juice in the Treatment of Rheumatism and Dys- 

menorrhoea. 

Mr. Middleton had lately tried, with much advantage, the 
use of lemon-juice in acute rheumatism. These cases pos- 
sessed the usual characteristics of the disease, and in some 
instances were secondary attacks. Iu some of the cases the 
first attack had lasted several weeks before the acute symp- 
toms had been relieved. Under the influence of lemon- 
juice, however, the pain was usually much mitigated, and 
in some instances removed in a few hours. He administered 
a purgative in the first instance, and then gave half an ounce 
of lemon-juice every four hours. As he had usually given 
alkalies with benefit in cases of a similar description, he 
was at a loss to understand how lemon-juice could act so 
beneficially. 

Mr. Headland said that the profession were indebted to 
Dr. G. 0. Rees for the use of this medicine in rheumatism. 
It had been employed by that physician, and by Dr. Babing- 
ton, extensively in Guy's Hospital. The fact was, that it 
had been too much the fashion to connect the cause of rheu- 
matism with cold. It was evident, from the success of the 
treatment of rheumatism by lemon-juice, that its origin was 
due to other causes. A great variety of remedies had been 
used in the cure of rheumatism, and he (Mr. Headland) be- 
lieved that other agents acted as beneficially as lemon-juice 
when they exerted the same action on the blood. Reason- 
ing on the effect of lemon-juice in cases of rheumatism, he 
had asked himself whether this medicine might not be em- 
ployed with equal benefit in other diseases. He had found 
it of most essential service in cases of obstinate dysmenorr- 
hea. He related one case in which all other remedies had 
been ineffectual, and in which the continued use of this reme- 
dy had effected a cure. It was remarkable that lemon- 
juice had not a tendency to act on the bowels, and where it 
had, or the constitution was in such a state as to allow it 
to be carried off by that channel, the medicine did not exert 
its special influence. 

Dr. Golding Bird hoped the time was not far distant when 
we should treat disease according to its essential charac- 
ters, rather than in reference to its name. Now, the cases 
mentioned by Mr. Middleton evidenced no paradox in re- 
gard to the treatment of rheumatism by alkalies and acid; 
for the lemon-juice and the carbonate of soda were essen- 



:LEM0N-JUICE IN RHEUMATISM AND DYSMENORRHEA. 19 

tially the same in their effects upon the system. He 
then proceeded at some length, which we regret our space 
does not allow us to report fully, to illustrate the effects of a 
morbid matter in the blood in the production of a train of 
symptoms which were attributed often to another cause; or, 
rather, the condition of the blood was not looked upon as 
the real and essential link in the chain of causation. Yet 
this fact could be evidenced by an examination of the secre- 
tions, particularly the urine. He illustrated his views with 
much force and ingenuity by a case of ague and a case of 
rheumatism. In both these cases there was a materies mor- 
bi in the blood, which, as the disease receded, was relieved 
by being carried off by the kidneys, a larger and larger 
quantity of solids being found in the urine. This he had 
always found to be the case in Guy's Hospital, in which he 
had treated these diseases on the principle of removing the 
materies raorbi. He believed that a similar condition of the 
blood to tnat which obtained in rheumatism was present in 
the patient affected with dysmenorrhoea mentioned by Mr. 
Headland. Now, in rheumatism, how were we to get rid of 
this morbid matter in the blood? Opium would remove it 
to some extent; colchicum would remove it. But it was 
taking a more common-sense view of the subject to employ 
some remedy which would eliminate the morbific matter 
from the circulation at once, by carrying it off by the urine. 
How, then, were we to effect this ? Why, in acute rheuma- 
tism, by the administration of cream of tartar, citrate of pot- 
ash, lemon-juice, or carbonate of soda. There was little dif- 
ference between the action of these neutral salts; but lemon- 
juice, which was a super citrate of potash, was more quick- 
ly absorbed into the blood, and consequently more active in 
effecting a cure. He had, however, in his own practice, 
been in the habit of employing the acetate of potash in these 
cases. This salt, with a mixture of sugar, water, and es- 
sence of lemon, acted with marvellous rapidity. In addition 
to this, given every four hours, he administered five grains 
of the soap pill, with opium, night and morning; for this not 
only relieved pain, but prevented the other remedy being 
carried off by the bowels. These, with the vapor-bath, con- 
stituted his treatment of rheumatism, and the result had 
been always successful. Soda and lemon-juice equally pro- 
duced an alkaline condition of the blood, but he prefered the 
acetate of potash, as it was not liable to be neutralized by 
the presence of acid in the stomach. In respect to the treat- 



80 Williams on cod liver oIl in phthisis. 

ment of ague, he never began at once with an anti-periodie> 
He always disgorged the liver by the employment of mild 
mercurials, and then some quinine. He mentioned one 
case, however, in which the quinine failed; he then gave the 
acetate of potash, and the case was cured. By these reme- 
dies we immediately altered the character of the blood, and 
cured the disease — a much more practical and philosophical 
mode of proceeding than that of treating disease according 
to name. — {London Med. Gaz.) — Charleston Med. Jour. 



On Cod Liver Oil in Phthisis.— -By Dr. C. J. B. AVilliams. 

Dr. Williams has retained notes of 234 cases of phthisis in 
which he has given cod liver oil. In nine cases the oil disa- 
greed, and was discontinued. In 19, although taken, it ap- 
peared to do no good, whilst in 206, out of 234, its use was 
followed by marked improvement, varying in degree from 
temporary retardation of the progress of the disease, and a 
mitigation of distressing symptoms, to a more or less com- 
plete restoration to apparent health. 

The most numerous examples of decided and lasting im- 
provement occurred in patients in the second stage of the 
disease. Even in a few days the cough was mitigated, the 
expectoration diminished in quantity and opacity, the night 
sweats ceased, the pulse became slower of better vo- 
lume, and the appetite, flesh and strength, were gradually 
improved. There was generally a diminution and gradual 
cessation of the crepitus; the breath-sound becoming drier 
and clearer; but the dullness and tabular character of the 
breath and voice sounds seldom exhibited any marked de- 
crease till after several weeks' use of the oil, in conjunction 
with counter-irritation. 

In the third stage, the effects of the oil are often very mar- 
vellous. The whole number of cases with one or more ca- 
vities, as indicated by physical signs, which, under Dr. Wil- 
liams' hands, manifestly improved, amounts to sixty-two. In 
thirty-four of these there was continued improvement up to 
the last reports. Eleven cases, which exhibited decided im- 
provement for a time, have since again declined or termi- 
nated in death. Of the remaining seventeen, he has had no 
recent report, and does not know whether the amelioration 
has been permanent or not.— Monthly Journal. 



CONTENTS 

OF THE 

NEW JERSEY MEDICAL REPORTER. 

FIRST MONTH, (JANUARY,) 1850. 



TRANSACTIONS OF THE NEW JERSEY MEDICAL SOCIETY, 

An Address delivered at the Semi-Annual Meeting of the New 
Jersey Medical Society, Nov. 13, 1849. By O. H. Taylor, M. D. 
(Medical Reform, and the Present System of Medical Instruc- 
tion.) - - 81 

Report of Committee on the Benevolent Fund, - - • 100 

Minutes of the late Semi-Annual Meeting, ... - 111 

Dr. Stratton's Resolutions, .---.-- 112 

Dr. Taylor's Resolutions, **-...* 112 

Dr. Parrish's Resolutions, - - - - - - • 113 

Dr. Lilly's Resolutions, .-•••-. 113 

Dr. Blauvelt's Resolutions, ----.,. 113 

Recommendation of the Standing Committee, • 114 

GLOUCESTER COUNTY MEDICAL SOCIETY. 

Address read before the Medical Society of Gloucester County, 
Oct. 31, 1849. By Thomas J. Saunders, M. D. 
(Lunatic Asylums, and the duty of Physicians respecting 
them,) 114 

BURLINGTON COUNTY MEDICAL SOCIETY. 

An Address delivered before the Burlington County Medical So- 
ciety, Oct. 16, 1849. By Joseph Parrish, M. D. 
(The Influence of the Uterus on the Female Constitution.) 121 

BIBLIOGRAPHICAL NOTICES. 

The present position of the Medical profession in Society — an In- 
troductory Lecture delivered in the Medical College of Georgia, 
Nov. 5, 1849. By Paul F. Eve, M. D. Professor of Surgery, 
Editor of Southern Medical and Surgical Journal, one of the 
late Vice Presidents of the American Medical Association, pub- 
lished by the class, - - 136 



CONTENTS. H 

Physician and Patient; or a practical view of the mutual duties, 
relations and interests of the Medical Profession and the Com- 
munity. By Worthington Hooker, M. D. New York — Baker 
& Scribner, 1849, -.---._. 138 

The Sanitary Condition of Philadelphia; from the Report of the 
Committee on Public Hygiene of the American Medical Asso- 
ciation. Read at the Annual Meeting, in Boston, 5th month, 
(May) 1849, and ordered to be published. By Isaac Parrish, 
M. D., member of the Committee. Philadelphia, T. K. & P. G. 
Collins, 1849. ... - 139 

BIOGRAPHICAL NOTICES. 

Biographical Notice of the late George McClellan, M. D. By G. 

S. Morton, M. D. 142 

The late Professor Harrison, 148 

EDITORIAL. 

New Jersey Prison Reform Association, - 151 

Dr. S. Woolston's Splint, * 153 

ECLECTIC DEPARTMENT. 

Remarks on Lead Poisoning, by R. J. Kittredge, M. D. * 154 

Rupture of the Spleen, (Autopsy) by M. G. Whitney, M. D. - 156 
On the Muscular Contractions which occasionally happen after 

death from Cholera, --- - - * - • 157 

Early Pregnancy and Infantile Menstruation, - * * 159 



THE 

MW JERSEY MEDICAL REPORTER. 

VOL. 1IL FIRST MONTH, (JANUARY,) 1850* No. 2. 
TRANSACTIONS OF THE N. JERSEY MED. SOCIETY. 



MEDICAL REFORM AND THE PRESENT^ SYSTEM OF MEDICAL 

INSTRUCTION. 

AN ADDRESS 

Delivered at the Serai-Annual Meeting of the New Jersey 
Medical Society, held at Camden, November 13, 1849, 
by 0. H. Taylor, M. D., one of the Vice Presidents. 

PUBLISHED BY ORDER OF THE SOCIETY. 

Gentlemen, Fellows, and Members of the Medical Society 
of New Jersey, — The revolution of another semi-annual 
term, has once more brought about the assemblage of the 
representatives of our profession, from all parts of the Com- 
monwealth of New Jersey ; and in accordance with time- 
honored custom, and your partial — I fear, too partial — selec- 
tion, it becomes my duty to address you, at the commence- 
ment of our deliberations, on this occasion." 

In looking around for a suitable subject upon which 
to engage the attention, my mind was naturally directed in 
the first place, to the more recent and novel forms of disease, 
and the improvements or proposed improvements in thera- 
peutics, which have been originated since our last semi-an- 
nual convocation ; but a little reflection convinced me, that 
subjects of this nature which will necessarily be discussed 
more fully in the elaborate reports from the several district 
committees, are more properly adapted to the regular mo- 
nograph, or treatise, in an established journal, than to the 
ephemeral lecture with which it has become customary to 
preface our labours. 

It seems more consistent with the true intention of such 
11 



82 dr. taylor's address. 

addresses, that they should offer for the consideration of the 
Society, plans of practical utility, and measures, calculated to 
uphold the dignity, and promote the usefulness of the medi- 
cal profession, the object and chief end of our foundation; 
than mere detailed narratives or even scientific arguments, 
such as may be properly introduced at any stage of our pro- 
ceedings ; and in accordance with this impression, 1 propose 
to offer some suggestions, calling for important and definite 
action on the part of the Society. 

The rapid increase of empiricism, and the consequent ex- 
tension of human suffering, disease, and death, during the 
last few years, have awakened much anxiety on the part of 
the profession, and given origin to many and learned disqui- 
sitions upon the causes of the evil, though rare indeed have 
been the measures of practical reform, suggested by the able 
minds engaged in the investigation. 

To protect the community of New Jersey from the conse- 
quences of gross ignorance, unprincipled cupidity, and inso- 
lent assumption, in the profession of medicine ; the charter 
of the Medical Society of New Jersey was originally grant- 
ed, and in furtherance of the same laudable object, its pro- 
visions have been modified from time to time, by the legis- 
lature, at our request. We have received from that instru- 
ment, many and singular powers, in contrast with that of 
other states of our union ; and we haye necessarily become 
charged with delicate trusts and important duties. The 
public has extended to us, privileges of important value, in 
consideration of our pledge to protect it from the dangers of 
empiricism and incompetence. The public has performed 
its portion of the contract faithfully. Have we been equally 
faithful in the moral and conscientious discharge of our part 
of the common obligation ? In attempting a reply to this 
most serious question, it becomes requisite for me to enter 
into an analysis of the more important rights and duties 
conferred and imposed upon us by the sovereign authority 
of the State; and we find one great end and purpose of our 



dr. taylor's address. 83 

creation, as a body of guardians of the public weal, tersely 
and briefly summed up in the fourteenth section of the act 
of incorporation, which commences with this significant 
provision — " And be it enacted, That this act shall be so 
construed as to prevent all irregular bred pretenders to the 
healing art, under the names or titles of practical Botanists, 
Root, or Indian Doctors, or any other name or title, involv- 
ing quackery of any species, from practising their deceptions, 
and imposing upon the ignorance and credulity of their fel- 
low citizens," &c. This section concludes with the proper 
reference to the pains, penalties, and processes, by means of 
which, it is prescribed that empiricism in New Jersey, shall 
be exterminated by this Society; and no one will pretend 
that these means are in any marked degree deficient or de- 
fective. By the provision of the twelfth section, it is made, 
not the privilege, but the legal duty of the district societies, 
to prosecute the delinquent in every instance of infraction of 
the law. 

Permit me'now, to inquire, to what extent this imposed 
legal duty has been performed by these district societies ? 
Are there no irregular bred practitioners, practical Botanists, 
or Indian Doctors, ungraduated Homoepathists, Tompso- 
nians, or Water Doctors, at present imposing upon the igno- 
rance and credulity of their fellow citizens within the imme- 
diate cognizance of the members of our district societies, and 
who are permitted to do so with impunity, and in defiance 
of the law of the land, through our culpable supineness? 

The late President of our Society, in his learned and elo- 
quent address, delivered at our last stated meeting, congra- 
tulated the profession upon the rapidly increasing confidence 
of the community of New Jersey in the counsel and skill of 
the regularly educated practitioner, and the subsequent de- 
cline of the evils of empiricism — but has he attributed this por- 
trait to the happy and important advantages derived from the 
proper and legal exercise of our duties ? the redemption of 
our pledges in accepting from the state our chartered rights? 



S4 dr. Taylor's address. 

Alas, no ! The community has grown wiser, and endued 
with power to discriminate between what is true, and what 
is false, and hence it is, that the diffusion of a superior 
grade of education, has enabled an increasing number of 
our fellow citizens to distinguish between true and false pre- 
tension. The people, it may be truly declared, have com- 
menced to guard themselves, in matters relative to health 
and life, and thus they are performing for us, those very 
functions which our corporate existence was created to fulfil. 

Gentlemen — I should be false to you and to myself in per^ 
mitting a spirit of flattery or self-laudation to check the ex^ 
pression of this serious and important opinion. So long as 
a single ungraduated empiric is permitted to endanger with 
impunity the health and lives of the citizens of New Jersey, 
in contravention of the laws of which we are the regular 
constituted guardians, so long the Medical Society of the 
State must be adjudged false to its trusts, and guilty of a 
breach of our contract with the state. 

If, then, this opinion be correct, is it not incumbent upon 
us, to enter upon an investigation of the causes, and extent 
of our dereliction of duty in relation to a subject in which 
our honor is directly concerned, as members of a corporation 
that is but a creature of the law and a servant of the public? 
Policy, as well as principle, obviously demands that we 
should act promptly and efficiently. The talented lecturer, 
who so recently addressed you, forewarns those of our pro- 
fession, who, neglecting the opportunities which surround 
them, fail to become solidly grounded in the art of healing, 
or suffer themselves to fall in the rear of the march of our 
science, that the public is becoming momentarily more ca- 
pable of estimating the distinction between the intelligent, 
well instructed, and accomplished practitioner; and the phy- 
sician who rests satisfied with adventitious means of success, 
and the comparatively slender amount of knowledge deem- 
ed requisite to warrant a commencement in professional 
life. If, then, our deficiencies in technical matters are thus 



dr. taylor's address. 85 

open to popular criticism, how can we safely calculate upon 
the forbearance of the people, under a much more obvious 
neglect of the plain letter of laws, enacted at our request — 
Laws, from which we have derived, and are still enjoying, 
the full measure of benefit. But the civic duties of the New 
Jersey Medical Society are not restricted to the extinction of 
extra professional quackery, and incompetence. Where is 
the respectable practitioner, whose indignation has slept, 
while witnessing the rapid deterioration of medical instruc- 
tion, and the constant diminution of the requisites of the de- 
gree of the Doctorate, within the last twenty years ? 

Schools have been multiplied to an unprecedented extent, 
by the numerous sovereignties of the United States, and 
over these schools preside, not the profession itself, whose 
interests are most immediately involved — not the people, 
speaking through the government, who might probably en- 
deavor, however blindly, to legislate for the protection of 
their own health and lives — but nominally, at least, certain 
associations of men, of visible standing in the community, 
elevated by their wealth and political influence, and it may 
be, a certain share of literary acquirements — men, who, ne- 
vertheless, are as ignorant as the general public, of the sci- 
ence in which they are called upon to determine the awards 
of merit. To men of this class, residing for the most part 
at the principal centres of intelligence, where their liability 
to injure life or limb, from the abuse of their high functions 
by the licensing of the unworthy or incompetent, is reduced 
to almost a nullity, we look for the legal certificates of me- 
dical ability, in the shape of a diploma. 

Let us look a little deeper into the operations of this sys- 
tem. It is not to be supposed that men so well instructed 
as those who constitute our Board of Collegiate Trustees, 
would undertake to determine for themselves, the qualifica- 
tions of aspirants for medical honors, while conscious of 
their own profound ignorance of the recondite principles of 
medical science j and we find that they have not in any in- 



86 dr. taylor's address. 

stance assumed such responsibility. They have invariably 
made over the duty of examining candidates to those who are 
alone capable of performing that all-important task ; those 
who are practically familiar with the art of healing. In 
this respect the dictates of common sense and propriety have 
been apparently obeyed. But to what class of practitioners 
has the management of examinations been referred ? Inva- 
riably to those, who are actually engaged in teaching, and 
who are therefore directly interested, not in extending the 
strongest guardianship over the health and lives of the com- 
munity, but in swelling the proportional number of gradu- 
ates annually sent forth from their own particular schools — 
for who is not fully aware that the reputation of easy exa- 
minations, and slender requirements, both in money and sci- 
ence, as preparations for the Doctorate, constitutes the high- 
est charm of a Medical School in the eyes of the trembling 
neophyte, who seeks to place his foot on the first round of 
the professional ladder ? What intelligent practitioner needs 
to be informed that the popularity and reputation of a col- 
lege are measured in the minds of the uninitiated public by 
the numbers of its class, and that those numbers are depen- 
dent, primarily and mainly, on the supposed lightness of ex- 
amination and the facility of graduation ? 

The only rational and worthy object of the institution of 
the Medical Diploma, is the protection of the public from 
the results of ignorant pretension in our divine art — yet there 
exists not in the United States a single independent ordeal 
of medical merit. 

In every School, the first preliminary question addressed 
to the candidate, is not, What do you know ? but, Where 
have you studied ? The second, is not, How long have you 
been reading and observing ? but, Whose ticket have you 
taken ? Now, there is no Esculapian cave, like that of 
Delphos, from which, by the peculiar favour of Apollo, the 
oracles of our art are uttered. Whence, then, arises this 
universal system of constantly multiplying monopolies, in 



dr. taylor's address. 87 

each of which the student, in order to enjoy the teachings 
of the truly wise in one or many departments of the Sci- 
ence, must be content to forego superior opportunities in 
other departments, because a Board of unprofessional Trus- 
tees have failed in securing the best talent, in every depart- 
ment for its own particular faculty? 

Why is the candidate, who has expended the largest 
amount of time and money, in obtaining the best instruc- 
tion, refused the right to claim a certificate of his qualifica- 
tions, because instead of studying exclusively in one or two 
collegiate establishments, he has chosen the best teachers 
from among all within his reach ? 

No disinterested observer will attempt to deny, that the 
existing system of exclusiveness, which confers the medical 
examinations to the holders of a certain ticket of matricula- 
tion, and obliges it to be conducted by and before those who 
have a direct and heavy interest in fulfilling the wishes of 
the candidate, wisely or unwisely, has degraded the teach- 
ing of medicine, from the loftiest occupation in the noblest 
of sciences, into a mere trade, to be conducted upon mer- 
cantile principles. That rivalry between schools which 
should lead to constant efforts to elevate the character of 
medical instruction, and to raise the moral value of the di- 
ploma, as a certificate, has been perverted, under the influ- 
ence of this mistaken system, to results, precisely opposite. 

Where the reputation of the school, and the emoluments 
of the professors are made to depend, not on the quality of 
the instruction, but directly upon the number of the matricu- 
lants, and the relative proportion of graduates, it would be 
asking too much of human nature to expect the dignity and 
usefulness of the profession to be advanced, or even upheld, 
in the face of a vigorous, and constantly increasing competi- 
tion ; and it cannot be a matter of surprise, nor will the fact 
be denied, that the value of the medical diploma is, and for 
years has been, depreciating, both in public and professional 
estimation. 



88 dr. taylor's address. 

Least any one should charge me with dwelling too 
strongly upon this point, I will quote, as a series of public 
efforts to correct this acknowledged evil, a resolution offer- 
ed by Dr. Bartlett, at a late meeting of the American Me- 
dical Association, at New York, and referred by that body 
to an able Committee— 

" Resolved, That the union of the business of teaching and 
licensing, in the same hands, is wrong in principle and lia- 
ble to great abuse in practice. Instead of Conferring the 
right to license on Medical Colleges, and State and County 
Medical Societies, it should be restricted to one board in 
each State, composed, in fair proportions, of representatives 
from its medical Colleges and the profession at large ; and 
the pay for whose services as examiners should, in no de- 
gree, depend upon the number licensed by them." 

I shall not attempt to occupy your time and attention 
with a critical analysis of the remedial measures advocated 
in this resolution. I have quoted it, merely in proof of the 
wide spread acknowledgement of the error of principle upon 
which the present system of medical instruction has been 
founded and hitherto conducted ; and it was no doubt ow- 
ing to a clear appreciation of the inevitable consequences of 
this system, that the legislature of New Jersey imposed upon 
this Society, the ditty of overlooking with care and watch- 
fulness, the simple, or mere certificate of a collegiate diploma, 
and discreetly, for the dignity of the profession, directed that 
even the graduates of other states should be subjected to an 
impartial examination by a board of our appointment, 
who were indifferent to personal interest, or private advan- 
tage, before being admitted to the legal privileges and im- 
munities of a regularly initiated practitioner of this State. — 
Let me then again solicit the question, how far the New 
Jersey Medical Society has, with integrity and moral recti- 
tude, complied with its obligations to the public in this re- 
spect ? Those amongst you who have been called upon to 
fulfil the delicate duties of the examiner, are painfully aware 
that while the legal tests of ability have been rendered gra- 



dr. taylor's address. 89 

dually less and less severe, partly through a misplaced, or at 
least, a very questionable lenity ; and partly, it may be, 
from the apparent necessity of the ease, arising from the de- 
terioration of elementary teaching. The number of instances 
in which our boards are compelled, unwillingly, to reject 
even the graduate applicant, in consequence of ignorance, 
too gross, and palpable, for concealment, is sufficient most 
amply to establish the wisdom of the legislative restriction, 
and the truthfulness of the unpleasant portrait, I have been 
compelled to represent before you. 

Will any conscientious medical practitioner, presume to 
condemn the laws by which we have been empowered, and 
directed to guard the citizens of New Jersey against the fic- 
titious pretensions of graduates, who, upon our examina- 
tions, have disclosed before our official boards, such peculiar 
qualifications as these ? — 

EXAMPLE, NO. I. 

Examiner — What are those medicines called, which in- 
crease,[or promote the discharge from the bronchial tubes ? 

Candidate — That was the very part I intended to study 
before examination. 

Examiner — What then do you mean by an expectorant ? 

Candidate — I can't exactly tell. 

Examiner— *Well, do you prescribe expectorants in your 
practice ? 

Candidate — Yes, Sir, by all means, 

Examiner—^ bw, as you have been in practice for sever- 
al months, allow me to inquire what is your favorite expec- 
torant ? 

Candidate — Jayne's Expectorant — and I use no other, 
because it is the best. 

Examiner — Can you tell me the constituents of Jayne's 
Expectorant ? 

Candidate — No, Sir. He will not tell that, 
1% 



90 dr. taylor's address. 

example, no. if. 

This young graduate came forward, with the strongest 
letters of recommendation from the highly distinguished 
professors of his school, as one who had won his medical 
honors, with unusual eclat. 

Examiner — What is the synonym of calomel? 

Candidate — I can't say, exactly. 

Examiner — How would you write a prescription for c«- 
lomel } and give me the full technical term ? 

Candidate — Hyd: Chlo: Mit: 

Upon further examination, this candidate insisted, that this 
practical contraction was the proper chemical title of the 
drug, in its entire length, and breadth, and gave ample evi- 
dence of his conviction, that all similar contractions employ- 
ed by pharmaceutists, were equally complete. Numerous 
other questions were answered by him, with a degree of ig- 
norance not less plainly manifest. 

EXAMPLE, NO. III. 

A graduate not less strongly recommended, under exami- 
nation for Obstetrics — 

Examiner — What do you mean by an hour-glass con- 
traction ? 

The candidate appeared embarrassed, and was unable to 
answer. The test was therefore applied in a different form, 
in order to give him time for reflection. 

Examiner — Well, then, Sir, what would you do in a 
case of hour-glass contraction ? 

Candidate — J would pass a wire. 

Gentlemen, were I disposed to cite some of the replies of 
graduated candidates, before our Board of Examiners, to 
questions in relation to the doses, and reagents of the more 
active medicinal poisons, every tendency to satire, would be 
lost in genuine terror, for the safety of human life, when en- 
trusted to the guardianship of such practitioners; but evi- 
dence has been already quoted, which may well cause us to 



Dr. Taylor's address. 91 

frown with indignation, while blushing with shame, and 
trembling anxiety, at these natural results of the existing 
condition of medical instruction, and the fearful negligence 
of those, who stand as sentinels before the portals of profes- 
sional life. It is not my object to dwell censoriously upon 
the conduct of others, but simply to direct your attention to 
the manner in which our own legal duties have been ful- 
filled. 

In Consideration of the rights, and advantages, bestowed 
upon us by law, we are required, by those laws, to protect 
the community of New Jersey against the evil consequences 
of such gross ignorance, and palpable incompetence 5 as I have 
just exposed. It is for this purpose^ and no other, that our 
charter prohibits even the regular graduate from commenc- 
ing the practice of Physic or Surgery within this State, (ex- 
cept in cases of consultation^ until he shall have passed an 
examination and received a diploma from the Medical So- 
ciety of NeW Jersey — that charter, exacting at the same 
time, heavy penalties for all breaches of this regulation, and 
making it expressly the duty of the district societies, in every 
county where such penalty shall be incurred, to prosecute 
for the same. 

Fellows, and fellow members, have we fulfilled our por- 
tion of this contract with the State ? Have we so prosecu- 
ted in every instance, as by the acceptance of our charter, 
We stand virtually pledged to do ? Plain truth demands the 
acknowledgment, that more than one of those young gradu- 
ates, whose replies to the simple questions of the examiners 
just stated, and were of course refused the license of this 
Society, though bearing the diplomas of schools of the very 
highest reputation, are now actually practising upon the 
ignorance and credulity of their fellow citizens, here, in our 
very midst, and are so permitted to do, in defiance of the 
laws of the State, and in the face of our legal obligation to 
abate the evil. 
The learned gentleman, to whose address I have more 



92 DR. f Aylor's address. 

than once alluded, compliments the community, and per- 
haps not unjustly, upon its growing capacity to scrutinize 
the attainments of medical practitioners, and remarks that 
66 if they be men of superficial attainments, and undisci- 
plined understanding,' the profession, no less than them- 
selves, will sutler from the scrutiny. 79 On the other handle 
when the rapid, and seemingly brilliant career of dashing 
pretension, rendered fearless by the very want of knowledge, 
is made a subject of sensorious comment amongst us, nothing 
is more common than the reply, that this apparent success, 
is but a transient evil — that, sooner or later, merit is sure to 
find its proper level; and hence the removal of such evils may 
be safely entrusted to the public itself, without involving the 
profession, in the vain, and endless task of endeavoring to 
restrain the inevitable, and constantly recurring consequences 
of a system, over which it cannot exercise control. 

This reasoning is as plausible, as it is convenient, to men, 
whose daily avocations are painfully engrossing, and whose 
efforts for the public weal are almost invariably attributed 
to selfish, and unworthy motives. It is true,, that the princi- 
ples of the science of life begin to be more widely discussed 
in popular lectures, and that class books on the subject, are 
rapidly becoming common in our academies, and elementary 
schools ; nor will any intelligent practitioner venture to im- 
pugn the opinion of the celebrated Rush, who, in one of his 
introductory lectures, contends that the general diffusion of 
such knowledge, is the most powerful antidote to both pro- 
fessional, and unprofessional empiricism, provided the teach- 
er be fitted for his office. But will it be pretended that the 
ignorance and credulity of our fellow citizens, have been al- 
ready so far enlightened, and removed by the peripatetic 
lectures, on the nature of man, and the compilers of school 
books on physiology, that the necessity, which led to our 
foundation, has passed away ? If so — why do we not de- 
clare our occupation gone ? Why does our charter still bur- 
den the records of the State ? Why do we not at once re- 



DR. TAYLOR 9 S ADDRESS. 9$ 

HnqUish to the Legislature, the immunities conferred upon 
its, in consideration of the guardianship over the public 
health, which we have so solemnly agreed to exercise ? 

There is ail ethical question involved in these considera- 
tions, which calls for serious reflection on the part of the 
society— does it not call for immediate action also ? Of 
what avail is it, that we reject the incompetent candidate 
for our license, when he appears before the confidential^ 
and almost secret tribunal of a board of examiners, if in de- 
fiance of law and duty, we surfer him the next day, to com- 
mence the very career, which our examination was insti- 
tuted to prevent ? If we permit him to pursue the practice 
of a profession, in which such ignorance inevitably leads to 
suffering, disease, and death, how shall we rebut the charge 
of countenancing homicide, by the mere pretext, that in time, 
such merit, will be duly weighed by the discerning public ? 

Gentlemen, I fear this discernment of the public is over- 
strained. While some of the best talent of the country has 
been occasionally employed in popular lectureship, upon sub- 
jects, calculated to render the uninitiated, more cautious in 
listening to the claims of unblushing pretenders to the heal- 
ing art — while some few men of real ability, and moral 
worth, have written works calculated to infuse into the 
minds of the young, a little genuine knowledge, of the first 
principles of Physiology and Hygiene, the country has 
been flooded with the open, or secret agents of the worst 
of acknowledged empyrics — male and female professors of 
crude, and dangerous absurdities — distributing false facts, 
false theories, false dogmas, and in many instances, catering 
even to the vicious appetites of their auditors, for the sake 
of spurious popularity. The employees of a host of pub- 
lishers of volumes, miscalled cheap, are perpetually travel- 
ing from city to city — from village to village, besieging the 
doors of every academy, and invading every school house, 
with the offer of their ill concocted compilations — rude tro- 
phies of the scissors. 



94 dr. tatlor's address. 

I have taken some pains to ascertain, from competent au- 
thority, the relative success of these impostors upon the ig* 
norance, and credulity, of even our learned fellow citizens^ 
whose avocations in life have not induced them to pursue 
the regular study of the divine art, in healing, and have 
reason^to believe, that where one individual in the commu* 
nity is found to possess that happy discrimination which en- 
ables him to recognize, and satisfy his thirst from the pure 
wells of physiological knowledge, there are ten, who rest 
content with poisonous draughts from the stagnant morasses 
of charlatancy and empiricism* 

How then can professional merit find its proper level, un- 
der the test of public scrutiny ? Look around you and de-* 
clare in what instances the medical practitioner has been 
liberally rewarded by the proceeds of his practice— that 
there are a few men of decided wealth, among the orna* 
ments of our science, is not to be denied — but whence was 
that wealth obtained ? Some are rich by marriage— some 
by hereditary fortune, or paternal estate*— some perhaps by 
speculation — but who are the millionaires of the Esculapian 
art ? In reply — we would respond to the truth; that, they 
are the venders of Catholicons, Panacea's, Expectorants, and 
Indian specifics— the manipulators in infinitesmal nonenti* 
ties, and wet sheets. Do these men find their level ? When 
they have accumulated fortune, does the public discrimina- 
tion, at length put limits to the growing mass ? It may be 
said, that this law of ultimate equilibrium, is only applica- 
ble within the ranks of the profession ; but human nature 
is not modified for the accommodation of costs, and experi- 
ence teaches, that the diploma is no talesman, endued with 
mystic power, to relieve the blindness of the public— no 
touch stone, by which to test the real metal, or expose the 
base alloy. 

If then, merit in our profession, tends ultimately to find its 
level, its movements through the adhesive mass of charla- 
tancy, by which it is surmounted, and surrounded, is so slow 



dr. taylor's address. 95 

arid gradual, that death usually arrives, in the midst of the 
precipitation, leaving pretension still paramount, and con- 
signing the family of modest merit, to the sympathy and 
kindness of its fellows, who have built their faith upon this 
popular, but illegitimate law. 

Let us then, discard an unbecoming apology, for our ne- 
glect, in leaving unperformed, an imperative, though disa- 
greeable duty. Let the society take immediate meas' A es to 
prevent their rejected candidates, from practising u~ on the 
ignorance, and credulity of their fellow citizens, at i nee, or 
request the Legislature to relieve us from the cumbersome 
machinery of a board of examiners, to test qualifications, 
which, when, found and declared deficient, are still imposed 
upon the public, under our tacit sanction. 

Allow me once more, to invoke your earnest attention, to 
the question, how far our action under the existing charter 
of the New Jersey Medical Society, comports with the mo- 
ral, and legal, obligations, and with the proper dignity of a 
professional body, endowed by their confiding countrymen, 
and who, under a persuasion of our fidelity, have committed 
to us, important trusts, and high responsibilities. 

So much for the duties enjoined upon us by the charter. 
But that instrument confers optional powers, as well as im- 
portant privileges, and essential obligations. 

In the course of my remarks, on the errors of the existing 
system of medical instruction, I made allusion to the opinion 
entertained by many, that the root of these errors, lies en- 
tirely beyond our reach — that we are powerless in attempt- 
ing to control, or modify, the system of medical instruction. 
Before closing these remarks, I will ask the attention of the 
society, to a few suggestions on this point. 

The same wise forethought, which induced the Legisla- 
ture to protect, by means of the New Jersey medical license 
system — the ignorance and credulity of the public, against 
the impositions of incompetence, armed with the diplo- 
ma, or not, appears also, to have engendered the anticipa- 



96 dr. taylor's address. 

tion of a "period, when the medical diploma, as uttered un- 
der the sanction of the various faculties, established on the 
ancient plan, would cease to be a certificate of merit — 
when the multitude of young graduates, poured forth from 
schools, in which the period, or quality, of preliminary study, 
has been, and still continues to be curtailed, in practice, if 
not in theory, might fail to supply the wants of the public, 
with a sufficient number of real, competent physicians. — 
What other consideration could have persuaded the Assem- 
bly of our State, to extend to us, the all-important privilege 
conferred in the fifth section of our charter ? 

" And be it enacted, That the Medical Society of New 
Jersey, (including both fellows and delegates) are hereby 
authorized to institute regulations, which shall again be ap- 
proved, by a majority of the whole number of fellows, act- 
ing separately, according to which regulations the said Me- 
dical Society of New Jersey, may confer the degree of Doc- 
tor of Medicine." 

Thus it appears, that although we are not required, we 
are permitted, to extend to the profession of our choice, and 
our affections, a portion of that guardianship, which it is 
made our legal duty, to exert over the health of the commit 
nity at large. 

If we are not empowered to correct the abuses of the ex* 
isting system of medical instruction, we are at least allowed 
to institute another, and a better plan, by which the requi- 
sites for graduation, shall be re-elevated to a standard of 
respectability, commensurate with the dignity, and vast im- 
portance, of our Heaven-born art. 

We have it wholly, and entirely, within our power, to es- 
tablish a diploma, which shall be a test of merit, because 
it would emanate from a body, fully competent to determine 
the question of medical ability. A body having no interest 
in the results of the examination, and no stake, in point of 
reputation, involved in the rejection of a pupil. 



dr. taylor's address. 97 

The want of such a model, is acknowledged on every 
hand. It was shown in the abortive attempt to act upon 
the charter of the Medical College of Philadelphia, in 1836. 
It is proved by the action of numerous medical bodies, since 
that time, in various parts of the United States. It re-appears 
in the resolution of Dr. Bartlet, before the American Con- 
vention, at New York. Why then, have so many efforts to 
palliate evils, that are universally condemned, proved una- 
vailing, and in every instance futile ? 

The answer, is as obvious, as the fact. The members of 
the several faculties of teachers, are among the most learned, 
the ablest, and most influential men, whose genius does ho- 
nor, and dignity to our art. They are properly put forward, 
and naturally assume controlling stations, in all general 
movements of the medical profession. They have made 
heavy investments in the business of teaching, and those in- 
vestments are secured to them by legal rights, really or seem-* 
ingly exclusive. Such faculties exist, in almost all the larger 
States, and everywhere, the immediate teachers of our pro- 
fessional youth, are made the immediate arbiters of their 
professional honors. 

Can it be expected of human nature, that reforms which 
would sap the very foundation of these rights — lessen per- 
haps, the value of investments, and leave hard-earned dis- 
tinction to maintain itself by ceaseless struggles with aspir- 
ing merit, should receive the unreserved sanction of the very 
holders of such valuable privileges ? Can we with reason, 
ask the valuable professor, to grant his aid in removing the 
well-cushioned arms from the professional chair, by throw- 
ing open the green room to every truly well educated can- 
didate, without inspecting his matriculation ticket. When 
we find by our examinations, how readily the incompetent 
are permitted to pass unscathed, that terrible ordeal by the 
aid of a small pasteboard talisman, endorsed with the image 
of the appropriate school, and superscribed to, by the appro^ 

priate Dean ? 
13 



98 dk. taylor's mmmwsu 

Wherever the tocsin of radical reform, in the teaching of 
medicine has been sounded, there the hopes of the sanguine 
have been crushed, and energies of the cautious, enervated 
by alarm, through the natural influences of those who cer- 
tainly cannot be regarded as totally disinterested judges of 
the propriety of measures, having direct influence on their 
emoluments, and fame, j 

But New Jersey has no medical school. No vested 
rights, as yet, exist in the hands of teachers.- No ancient 
system, honored alike in its use and its abuse, interferes with 
the calm deliberation of disinterested men upon the wants of 
the professional public, and the means of restoring and elevat- 
ing the properdignity, of the noblest, and most liberal of sci- 
ences. Here then, if any where, we might cherish the hope, 
for the foundation of a medical school, in which the requi- 
sites for graduation, might be placed upon a proper basis. — 
Where the teacher should be forever cut off from the dan- 
gerous privilege of sitting in judgment, upon the results of 
his own mental tabors. Where the accomplished candidate, 
might be secure of justice, without irrelevant inquiry as to 
where his knowledge was acquired. 

And where the diploma, rendered difficult of acquisition 
by the severity of the scientific tests alone, might become 
what it was originally designed to be — a legitimate certifi- 
cate of unquestionable ability. 

. I am aware, that all action upon the powers conferred by 
the fifth section of our charter, must be surrounded by diffi- 
culties, and encumbered with questions, of the utmost delica- 
cy. Time, and the most careful deliberation, would be ne- 
cessary at every step. 

Whether the present be the proper season for a movement 
in favor of a reform of the present system of medieal in- 
struction, I leave the society to decide ; but in calling your 
attention to this subject, 1 have performed a simple duty, in 
the hope of relieving this venerable and time-honored asso- 
ciation, from the charge of luxuriating in privileges unpaid 



br. taylor's address. 99 

for, or resting idle, in the midst of powers unexercised, and 
duties unperformed. 

Let me now conclude, with an apology for the somewhat 
unusual character of this address. A medical life, is a life 
of reflection, and scientific observation. 

The avocations of the closet, and sick room, call us off from 
the details of ordinary affairs, and perhaps no class of the com- 
munity, are more habitually averse to the routine of busi- 
ness. Prone as we are, in hours of leisure, to meditative 
thought, and in our more active pursuits, to recondite inves- 
tigations, and abstract discussion, we too frequently become 
neglectful in our civic duties. This has been my motive in 
quitting the beaten track, and instead of occupying your 
time, with a disquisition upon professional ethics, or an essay 
upon some practical, or theoretical questions in medical sci- 
ence, I have regarded the New Jersey Medical Society, ra- 
ther as a civic institution, the creature of the law, established 
for a social purpose, than as a body of philosophers, engaged 
in the treatment of disease. 

New Jersey has contributed her full quota of enterprise, 
and talent, in all other departments of human affairs. The 
walks of mercantile Ufe, the theatres of industrial energy, 
the bench — the bar — the halls of legislation, are graced on 
every side by bright stars from the galaxy of genius, claim- 
ing the institutions of New Jersey, as the fountain of their 
light, though the illumination of their rays extends from 
ocean to ocean, and from the frozen plains of the north, to 
the southern boundaries of the Anglo-Saxon race. 

Has the most noble, and dignified of . all professions, contri- 
buted its proper share to this assemblage of distinction ? — 
perhaps the query may admit an affirmative reply — but the 
medical profession of New Jersey, holds at the present mo- 
ment, the power to place her in advance of all her sisters, in 
the march of medical reform, and if in the few remarks, 
ivhich time, and the important objects of this meeting 
have permitted me to offer, I should elicit an initiative 



100 REPORT ON BENEVOLENT FUND. 

thought, which in its future developments, should lead to a 
result, so glorious, I shall feel myself in part released from 
the deep debt of gratitude, so justly due to the profession 
we delight to honor — the State of my adoption, in which I 
have received so many proofs of courtesy and confidence, 
and my fellow members of this Society, whose patient at- 
tention, and kind countenance/demands, as believe me gen- 
tlemen, they heartfully receive — my ^warmest thanks. 



REPORT OF COMMITTEE, ON THE BENEVOLENT FUND. 

The following Resolution was adopted at the last Annual 
Meeting of this Society, viz : 

"Resolved, That the President of this Society, be autho- 
rized to appoint a Committee whose duty it shall be to en- 
quire into the expediency of establishing a fund for the relief 
of the families of such regularly licensed physicians through- 
out the State, as may hereafter die in indigent circum- 
stances : and that the said Committee be instructed to report 
at the next meeting." 

The Committee appointed under the above resolution re- 
spectfully report, that they have had the subject referred to 
them, under careful consideration. In approaching a sub- 
ject so fraught with interest to the profession, they regret 
that the difficulty of obtaining positive information, has pre- 
vented them from doing that full justice to it, which its in- 
trinsic merits would seem to demand. Treading, in a great 
measure, upon new ground, they have felt the want, at 
every step, of that certain knowledge, which a familiarity 
with the practical working of similar organizations can 
alone supply. This is the more to be regretted, inasmuch 
as practical experience would seem to be essential to the 
successful creation of a comprehensive charity, such as is 
contemplated in the resolution. Such a charity, the Com- 
mittee are confident, would not only reflect the highest credit 
upon this body, but be instrumental in effecting a great 
amount of good. 



REPORT ON BENEVOLENT FUND. 101 

No object can be more praiseworthy, than that under con- 
sideration. To relieve the necessities of the widow, and the 
orphan, is at all times one of the noblest exercises of charity; 
but, when these claimants upon our benevolence, are allied 
to us by the bonds of professional brotherhood, the duty be- 
comes doubly imperative. 

The moral and social results, to be anticipated from the 
association of the members of a liberal and enlightened pro- 
fession, for the purpose of sustaining each other when dis- 
ease, or misfortune, shall overtake them, would, of them- 
selves, justify the contemplated enterprise. There are few 
pursuits in which associated charity, can have a larger, or 
more fruitful field for its legitimate exercise, than the prac- 
tice of medicine. No occupation is perhaps so fruitful in 
risks to life, and health. Few, are more unfavorable to the 
acquisition of wealth, or whose members more frequently 
bequeath indigence to their families. 

No rank, or grade, of the profession, would seem to be ex- 
empt from the contingencies sought to be provided against, 
in the contemplated charity. The most distinguished, for 
professional skill, and attainments, as well as those less 
known, have had their last hours embittered by the con- 
sciousness of being compelled to leave those most endeared 
to them, dependant upon the cold charity of the world, for a 
precarious subsistence. The Committee need but to refer to 
the instances of Sir Charles Bell in Europe, and of Profes- 
sors Godman, and Dewees in this country, to sustain the 
truth of the above remark. These are, however, but well 
known examples in its higher walks. They bear no pro- 
portion to the number of those which occur in the entire 
profession. There are perhaps few present, who cannot 
call to mind some instance of a medical friend, or cotempo- 
rary, who, after a life of toil and sacrifice, has left his family 
with but a pittance for their support. 

It is to the task of preventing, as far as may be, the fu- 
ture recurrence of such melancholy accidents that your Com- 



102 REPORT ON BENEVOLENT FUND. 

mittee would earnestly address themselves — a task, proved 
by the successful organization of similar institutions, both in 
this country, and in Europe, to be perefectly feasible. The 
creation of a charity by this society, the influence of which 
will be exerted in gladdening the hearts of the widow, and 
the orphan of the medical man, and soothing his last hours 
with the prospect of pecuniary aid, if needful, to his family, 
the Committee feel, would be an enviable epoch in its hisr 
tory. As the oldest state medical organization in the Uni* 
ted States, they are confident that it cannot but feel emulous 
of immediate, and energetic action, in so good a work. 

It has been stated that similar enterprises have been &U 
tempted, both in this country, and in Europe. Several of 
these have come to the knowledge of the Committee. An 
association, having for its object, the relief of the families of 
medical men, dying in indigent circumstances, has been in 
successful operation, in the city of London, for the last fifty 
years. It was commenced by seven individuals only, and 
has at this time, a funded capital of 225,000 dollars. It dis- 
tributes annually 7,500 dollars among the widows, and chilr 
dren, of its deceased members. The history of this society 
exhibits the startling fact, " that of the families of its mem* 
bers, deprived of their paternal head, nearly one fourth are 
left destitute," and dependant upon that charity for support. 

A similar society has recently been established in the 
city of Dublin, and is said to be in successful operation. The 
Provincial Medical and Surgical Association of England has 
also established a " Benevolent Fund," for the same pur- 
pose, "the management of which, the Committee are in- 
formed, covers nearly all that section of the kingdom, and is 
productive of the most gratifying results." 

In our own country, too, the Committee are happy to say, 
that the profession are not altogether insensible to the claims 
of fraternal charity. They have been supplied with a copy of 
the Constitution and Bye Laws of the " New York Society 
for the relief of the Widows and Orphans of Medical men." 



REPORT ON BENEVOLENT FUND. 103 

That association was organized in 1842, is now in success- 
ful operation, and affords the most gratifying evidence of the 
entire expediency of such enterprises, in our country. — 
Though confined to the cities of New York, and Brooklyn, 
and their immediate neighborhood, it already numbers 70 
members, and has a capital of nearly 6000 dollars. Among 
its members the Committee are pleased to observe the names 
of Stearns, Mott, Stevens, Delafield, Post, Parker, and others, 
scarcely less distinguished in their profession. A brief 
sketch of some of the leading features of this institution, may 
not perhaps be out of place in this report. Each member 
pays an initiation fee often dollars, and an annual contribu- 
tion, of the same amount ; the latter payable semi-annually. 
The sum of one hundred dollars, if paid within three months 
after his election, constitutes the person so paying, a life 
member, and is a compensation for all future pecuniary de- 
mands upon him. No member, who is an annual contribu- 
tor, shall be called upon to pay his annual subscription, for 
a longer period than twenty years, at the expiration of which 
time, he shall be considered a life-member. The number of 
life members Jn 1848, was nineteen. Five members joined 
the society during that year, and three members have died 
since its organization, or during a period of six and a half 
years. The funds of the Institution are directed by law, to 
be invested, in bond and mortgage security upon real estate, 
in the cities of New York, and Brooklyn, and in stocks of 
the United States, and of the State of New York. The wi- 
dow of any member, having no child, and who has no es- 
tate, salary, or other provision, exceeding the yearly value of 
two hundred dollars, is entitled to receive annually, not less 
than one hundred and twenty -five dollars, and for each child 
under fifteen years, fifty dollars. These sums are to be in- 
creased, if the funds of the society permit. No family can 
draw upon the funds of the association, unless its deceased 
head, shall have been a contributor for two years, or more, 
previous to his death. 



104 REPORT ON BENEVOLENT FUND. 

The above is the only instance of a similar enterprise, in 
this country, of which the Committee have any knowledge. 
They believe that, with some modifications, its modus ope- 
randi would afford a satisfactory basis, upon which to erect 
a similar institution in New Jersey* 

The history of all the above institutions proves conclusively 
the fact, that a few medical men can, by the annual pay- 
ment of a small sum of money, if it be well managed, accu- 
mulate in a few years, a capital, the revenues from which, 
will be sufficient to meet all charitable demands, that may 
be made upon it. 

The Committee will now proceed to enquire into the pro- 
bable nature, and frequency, of those demands. There are, 
in their opinion, three legitimate objects to be attained by 
the proposed enterprise — viz: The relief of the physical 
wants of the families of deceased members, when in health. 
Relief of the sick, in such families, and assistance to super* 
annuated, or disabled members, during life. 

The relief of the physical necessities of such families, as 
are left in indigent circumstances, will require the largest ex- 
penditure of the funds of the institution, inasmuch, as such 
demands will most probably exceed in frequency, all others. 
The experience of the London Society, already referred to, 
is, that nearly one fourth of the families of its deceased mem- 
bers, require the aid of the association. It is probable that 
the proportion of recipients would not be so large in this 
country. Admitting, however, that the same proportion of 
cases should occur— if the experience of the New York So- 
ciety, be taken as a criterion, by which to estimate the de- 
gree of mortality among the contributors, there would not 
be a recipient for the favors of the trust, during a period of 
less than eight years. The Society referred to, it has been 
seen, lost but three members during a period of six and a 
half years. If this estimate be correct, the proposed asso- 
ciation would be called upon to support one family, during 
the first eight years of its existence. After the lapse of this 



REPORT ON BENEVOLENT FUND. 105 

period, the demands upon the trust would most probably 
multiply with greater rapidity. The infancy of the institu- 
tion would, however, during this period, have passed over, 
and its funds have accumulated to such an extent as to be 
sufficient to meet all demands arising from such an increase. 

The relief of the sick, though not so frequent, would be a 
more pressing and immediate demand, and one that would 
require more prompt assistance. The drafts iipori the Asso- 
ciation from this cause; would therefore, neither be so fre- 
quent, nor of such duration, as those required for the phy- 
sical support of the recipients. The custom of rendering pro- 
fessional services, in all such cases, free of charge, would 
materially diminish the demands from this cause. 

Relief to disabled or superannuated members, when in 
destitute circumstances, though not strictly comprised in the 
resolution which heads this report, would seem to be a le- 
gitimate subject for the consideration of the committee. The 
member, who has grown grey in the active duties of his pro- 
fession, without having received a just reward for his exer- 
tions, and who finds himself, from disease or decrepitude, 
no longer able to continue them, perhaps after having con- 
tributed his quota to the funds of the Association, for many 
years, should not be permitted to languish in want. It 
should be one of the highest aims of the society, to ena- 
ble him to spend the evening of his life in comfort. The 
committee would therefore suggest, that some provision be 
made for this object. In their opinion, the contemplated 
charity would be imperfect without it. But the most im- 
portant question connected with the proposed enterprise, is 
the practicability of raising the requisite funds. The prin- 
cipal difficulty may be anticipated to arise here. It is the 
opinion of the committee, that sufficient pecuniary means 
can be accumulated, to insure the success of the undertak- 
ing, without imposing an onerous tax upon the contributors. 
The plan they would propose, as in all respects, the"most 

practicable, is by individual contribution. They have been 
14 



106 REPORT ON BENEVOLENT FUND. 

favored, with the views of a distinguished physician of Phi- 
ladelphia, who has had much experience upon this part of 
the subject — and they take this opportunity of expressing" 
their obligations to that gentleman, for much valuable mat- 
ter with which he has supplied them.* 

The experience of the gentleman . referred to is, that to 
secure a weekly allowance of three dollars, in all cases of 
sickness,, not the result of crime, among one rrundreel ox 
more healthy individuals entering an association before their 
sixty-first year, it will require, in addition to the expenses of 
managing the trust, a yearly contribution of $3.25 

To secure decent funeral expenses to the families of 

those who may die,* an additional contribution of .50 

To secure similar advantages to those who enter 
such an Association in health, and afterwards be- 
come affected with consumption, or other consti- 
tutional diseases, an additional sum of 1.00 

Which by adding the deficient fraction of 25 cents 

will make a total of $5.00 

It would appear from the above statement, that, by the 
payment of five dollars per annum each, all the members of 
an Association, numbering one hundred or more, can be as- 
sured three dollars per week, during sickness, not the result 
of their own crimes. 

But the object of the contemplated fund, is not to relieve 
all the contributors, but merely the families of those in indi- 
gent circumstances. The demands upon it, will therefore, 
be much less frequent, than in the case of a Beneficial Soci- 
ety, where each member who may be sick, is entitled to 
draw his weekly allowance, during indisposition. Again, 
several years would elapse, before each member would be- 
come a pensioner, upon the bounties of the society. These 
circumstances would give time for the funds, if judiciously 
managed, to accumulate to such an extent, as to insure am- 



Dr. Reynell Coates 



REPORT ON BENEVOLENT FUND. 107 

pie means for the fulfilment of all its pledges. But, to ren- 
der assurance doubly certain, the committee would recom- 
mend that the funds be allowed to accumulate for a fixed 
period, say five or ten years, before any payments be made 
to contributors. 

If, for instance, the initiation fee be fixed at five dollars, 
with an annual contribution of the same amount, and one 
hundred members be obtained, the association would com- 
mence its operations with a capital of five hundred dollars. 
Such a capital would, if invested on bond and mortgage se- 
curity, at six per cent, and united with the annual payments 
similarly invested, amount in ten y^ars, to the sum of six 
thousand five hundred and ninety dollars, with an interest 
of three hundred and ninety-five dollars per annum — which 
latter added to the annual contribution would, even allow- 
ing that no additional subscribers to the society be obtained, 
during the above mentioned period, amount to an annual 
revenue of eight hundred and ninety-five dollars : a sum in, 
the opinion of the committee, every way sufficient for the 
purposes of the association at its commencement. An ad- 
ditional capital might probably be accumulated, by the insti- 
tution of life memberships, with payments in advance. Some 
aid might also be anticipated from donations, .after a few 
years. 

It will be seen from the above calculation that the propos- 
ed institution could, at the end often years, expend annual- 
ly the sum of eight hundred and ninety-five dollars, without 
encroaching on its invested funds. But if the London so- 
ciety increased in fifty years, from seven members, to its 
present large numbers, and handsome capital, may we not 
safely presume upon an increase, though not, perhaps in the 
same ratio. During the first six months of the year 1S42, 
that institution sustained thirty-one widows, and fourteen or- 
phan children, and paid out three thousand two hundred 
dollars ; yet notwithstanding this large outlay, there was an 
addition of five hundred dollars, made to the funded capital 



108 REPORT ON BENEVOLENT FUND. 

of the company during that period. If such results have 
been realized in England, may not New Jersey reasonably 
hope to do good, though on a smaller scale. May not the 
circle of her medical charities be anticipated to widen 
with coming years, and the influence of example. 

In naming one hundred, as the probable number of contri- 
butors, the committee believe they have formed a tolerably 
correct estimate. Judging from such imperfect statistics, as 
they have been able to obtain, there are from two hundred 
and fifty, to three hundred regularly licensed physicians, in 
active practice in the State, a majority of whom, are sup- 
posed to be favorable to the project But if no more than 
fifty names be obtained at the commencement, the associa- 
tion would commence under favorable auspices. If the 
number of members were small, so also would be the num- 
ber of demands upon the charity of the institution. 

If, as has already been suggested, provision for life-mem- 
berships, and donations be made, the increased amount of 
capital that might thus be made to flow into the associa- 
tion at its commencement, would materially advance its pro- 
gress. The payment in advance of a certain sum, say fifty 
dollars, at the time of his application, might be made to con- 
stitute the individual a life member. If due provision were 
made, an occasional donation, either from wealthy or chari- 
table members of the. profession, or perhaps from non-pro- 
fessional persons, might also be anticipated. The New York 
Society, acting upon this presumption, has established the 
honorary title of Benefactor. The payment of one hundred 
dollars, by a person not a member of the profession, or of 
one hundred and fifty dollars by a member, constitutes the 
person so paying, a "Benefactor of the Society." 

In regard to the management of the funds of the proposed 
institution, the committee would remark, that so far as they 
are aware, the only mode of investment, authorised by the 
Orphan's Court of New Jersey, for the funds of Orphans, 
is by bond and mortgage security on real estate. They 



REPORT ON BENEVOLENT FUND. 109 

would therefore recommend a similar mode of investment, 
as in all respects the most advantageous. 

Your committee are divided upon the question, whether 
the proposed charity, shall be incorporated with this socie- 
ty, or be organized, as a separate institution. A minority 
is in favor of a separate organization, meeting at the same 
time, and place, with this body. The majority, think that 
it would be more advantageous to unite them. Two ad- 
vantages, would, in their opinion, accrue from their union, 
viz: greater facility and economy, in the management of 
ihe trust: and, a more thorough enlisting of the 'esprit du 
corps' of the profession of the State, in favor of the enter- 
prise. 

Greater economy, because, by such an arrangement the 
officers of the State society, might, to a great extent, be 
made the officers of the trust. A small addition to their pre- 
sent salaries, would compensate them for\my extra labor, 
they would have to incur. The principal consideration, af- 
ter the foundation of the association, would be to secure the 
prompt payment of the annual dues. Arrangements would 
have to be made, for urging payment upon tardy and dis- 
tant members, and these, to be effectual, would have to be 
made in every county of the State. To effect this by local 
organizations, would be both expensive and uncertain. By 
an union with the parent society, the officers of the district 
societies, might be made the agents of the trust. The great- 
er economy of such an arrangement, will be apparent. 

Such a plan, the committee believe, would more thorough- 
ly enlist the 'esprit du corps 7 of the profession, in favor of 
the enterprise, from the following considerations. The as- 
sociation, to be successful, must extend itself throughout the 
State. Isolated practitioners, having but little personal 
communication, must necessarily make up the sum of the 
contributors. Between these, there exists at present, no 
bond of union, save that supplied by their relationship to the 
State society. To create such a bond, by a separate insti- 



110 REPORT ON BENEVOLENT FUND. 

tution would be difficult, if not impossible : and even were 
it possible, it would be, in the opinion of the majority of 
your committee, a work of supererogation to create afresh 
that which already exists, and which they believe can be 
made available for the purpose. Further, a separate organ- 
isation would, it is believed, weaken the already flagging 
interest of the profession in this body, by diverting it into 
another channel ; while an union of the two would awaken 
a fresh feeling for it, as the parent of so benevolent an en- 
terprise. Individual interest, and a becoming professional 
pride, might thus be made, to unite in sustaining both the 
parent and its praiseworthy offspring. 

Thus far, the practicability of founding the proposed fund, 
would seem to be established. But the committee, regret to 
say, that there exists, an insuperable barrier, to the success 
of the project, in the present charter of this society. Un- 
willing to hazard an opinion, upon their own responsibility, 
they have taken legal advice, upon this point From the 
tenor of that advice, and their own convictions, founded 
upon a careful examination of the act of incorporation, they 
are unanimously of the opinion, that, when fairly interpre- 
ted, there is nothing in the spirit, or design of that instru- 
ment, that would sustain such an addition to its present 
powers. It will, therefore, be necessary to procure from the 
Legislature, an addition to the privileges already granted in 
that document. This, they believe, might easily be eifected 
by means of a supplement, to the present charter, specifying 
the nature and object of the proposed association. They 
have obtained, from a legal gentleman of high standing, a 
form for such a supplement, which they present, with this 
report, for the consideration of the society. 

In conclusion, the committee, though at the risk of unne- 
cessary repetition, would urge the founding of the proposed 
fund, for a reason not hitherto sufficiently insisted upon. — 
They would urge it as a means of strengthening and perpetu- 
ating the existence of this body, as a means of sustaining and 



MINUTES OF LATE MEETING, 111 

fostering that esprit da corps, upon which the medical Society 
of New Jersey depends, more than upon any other agency, 
for its existence and prosperity. The contributors to such a 
fund, being also members of this body, and feeling them- 
selves bound, together,' by the combined ties of professional 
amity, and interest, would, it is believed, repair to its meet- 
ings with renewed energy. They would feel, that to sus- 
tain the parent, would be but to sustain its charitable off- 
spring. Charity would operate in this instance, as it always 
does, by covering a multitude of imperfections, and our time- 
honored institution, never, perhaps, more endangered than 
at present, by a false public sentiment, would have made 
one step more, in accordance with the spirit of the age, and 
the demands of the profession. 

All of which, the committee respectfully submit, &c. &c. 

Signed, Q. Gibbon, "] 

L. Condict, „ ... 

r. u rx, > Committee. 

0. H. Taylor, [ 

E. J. Marsh, J 



MINUTES OF THE LATE SEMIANNUAL MEETING. 

The semi-annual meeting of the "Medical Society of New 
Jersey," convened at Elwell's Hotel, Camden, Nov. 13th, 
1849, at 11 o'clock, A. M. 

Dr. John H. Phillips, 2d Vice President, took the chair, 
and called the meeting to order. 

Dr. Wm. Pierson, the Recording Secretary, being absent, 
on motion of Dr. J. B. Munn, Dr. Thomas J. Saunders was 
appointed Secretary pro tempore. 

The minutes of last meeting, not being on hand, the coun- 
ties were called in order, for delegates. Ten district socie- 
ties were represented, viz : Somerset, Hunterdon, Morris, 
Monmouth, Mercer, Burlington, Camden, Gloucester, Sa- 
lem, and Cumberland. A number of physicians were pre- 
sent, not delegates, but members of various District socie- 



112 MINUTES OP LATE MEETING, 

ties. Also, Doctors Benjamin H. Coates, Isaac Parrish^ Jo- 
seph Warrington, and Reynell Coates, of Philadelphia ; and 
Dr. Wilmer Worthington, of West Chester, Pa; 
On motion of Dr. B. H, Stratton, it was 

"Resolved, That all physicians not delegates, who may be 
present, be invited to seats in this meeting/' 

An essay was read by Dr. 0. H. Taylor, 3d Vice Presi- 
dent, entitled, "Medical Reform, and the present system of 
Medical Instruction:" upon its conclusion, the thanks of the 
society were voted to Dr. Taylor, and a copy of the address 
requested for publication, 

Dr. Q. Gibbon, from the committee on the Benevolent 
Fund, appointed at the annual meeting, made a detailed re- 
port, in favor of its being established, and presented the 
form of a supplement to the medical law, calculated to ef- 
fect the object in view. The report was accepted. The 
form was amended and adopted ; and, Drs. J. W. C. Evans, 
J. B. Coleman, and J. H. Phillips, were appointed a com- 
mittee, to procure from the next legislature, the passage of 
the supplement as framed and amended. 

The President, (Dr. Jos. Fithian,) presented, and read a 
communication, from Dr. Lorenzo F. Fisler, of Camden, de- 
fining his position as a licentiate. After some remarks had 
been made by Dr. Fithian and others, in corroboration, Dr. 
0. H. Taylor, moved the following preamble and re-solu- 
tion, which were unanimously adopted : 

" Whereas, many years ago, our highly respected fellow- 
citizen, Dr. Lorenzo Fisler, regularly, and legally subjected 
himself to an examination, before the proper board of ex- 
aminers, for the district in which he then resided, and duly 
received from them, the usual certificate, entitling him to 
a diploma of license, from the "Medical Society of New Jer- 
sey," which certificate was afterwards, for a long time lost ; 
moreover, whereas, much misapprehension upon this subject, 
has occurred, giving rise to erroneous statements, question- 
ing the reception of a certificate by Dr. Fisler, and in other 
respects, doing him injury in his professional reputation, or 
interest — therefore, 



MINUTES OF LAST MEETING. 113 

"Resolved, That the President of the "New Jersey Medi- 
cal Society/' be authorized to issue a diploma of license to 
the said Dr. Fisler, in a manner which he shall deem most 
agreeable to the feelings of the recipient, and best calculated 
to make amends for the unintentional injustice committed 
by the society in the premises;" 

Dr. Joseph Parrish presented the following preamble and 

resolutions : 

"Whereas, the Medical Society of New Jersey having ex- 
isted, since the year 1772, and having, during most of that 
time, since its organisation, been active in promoting the in- 
terests of the medical profession ; and, whereas, the policy 
of separating the teaching, and licensing powers, having been 
early adopted, and always acted upon, by the medical pro- 
fession of New Jersey — it is therefore, 

"Resolved, That the testimony of this society, is decided- 
ly in favor of establishing boards of examiners, separate from 
the medical faculties of the different medical schools. 

"Resolved, That our representatives to the next meeting 
of the American Medical Association, be instructed to sup- 
port such action as may be taken by the Association, upon 
this subject, as will accord with the principles and experi- 
ence of this societv." 
ti 

Which were read, considered, and unanimously adopted. 

On motion of Dr. Lilly, it was 

Ordered, That the Treasurer be authorised and instructed, 
to purchase a copy of the proceedings of the "American 
Medical Association," for the year 1849, for each of the 
District societies. 

On motion of Dr. Blauvelt, the following was adopted : 

"Resolved, That hereafter the notices of the annual and 
semi-annual meetings of this society, be published with the 
regular proceedings of the society, in the "New Jersey 
Medical Reporter." 

The bill of Dr. R. M. Cooper, as delegate to the American 

Medical Association, ($24.00) and the bill of A. S. Barber, 

for printing ($3.50), were respectively ordered to be paid 

by the Treasurer. 

Adjourned, till 3 o'clock, P. M. 
15 



114 DR. SAUNDERS'S ADDRESS. 

At 3 o'clock, P. M., Dr. Phillips again took the chair, and 
the society came to order. 

Dr. J. B. Coleman, from the Standing Committee, present- 
ed the following communication : 
"To the Medical Society of New Jersey : 

The undersigned. Standing Committee of your body, 
hereby recommend, that the honorary degree of Doctor of 
Medicine, be conferred upon Dr. John Bowne, of Hunter- 
don, Nathan W. Condict, of Morris, and Jacob T. B. Skill- 
man, of Middlesex counties, licensed practitioners of many 
years standing. 

James B. Coleman^ 
J. J. Dunn, 
J, L. Taylor." 
Camden, Nov. 13, 1849 s .* 

Which was read, and in accordance with the by-laws, 

laid over until the annual meeting, to be then acted upon. 

Ordered, that Dr. English, the Treasurer, pay the bill of 

expenses for the day. 

The Society then adjourned!. 

Thos. J. Saunders, 

Secretary ', pro tern. 



LUNATIC ASYLUMS; AND THE DUTY OF PHYSICIANS RE- 
SPECTING THEM. 

Read before the "Medical Society of Gloucester County" 
New Jersey ', at its Semi-Annual meeting, Oct, 31, 1849. 
By Thos. J. Saunders, M. D. 

Gentlemen :— One of the distinguishing features of Ame- 
rican character, is the disposition to indulge in acts of prac- 
tical benevolence. A kindly feeling, prevails among all 
classes of society, towards those who are in affliction, and 
means are seldom wanting to relieve distress. In private life, 
this is particularly to be seen, and, as an evidence of the 
fact, we have only to show to the foreigner, visiting our 
shores, the streets of our cities, destitute of mendicants, and 
our villages, without an apparent pauper. The people of 
our country, have been so trained, that no sight would be 



DR. SAUNDERs's ADDRESS. 115 

more revolting to them, than to he constantly surrounded by- 
beggars. If a small community becomes aware of the fact, 
that suffering exists, there are those, who are always ready 
to lend a helping hand, and to give a word of comfort. The 
spirit, which animates the individual, has given tone to the 
masses. Our respective Legislatures, are almost always 
ready to do an essentially good action— one, which brings 
into play, the better feelings of the heart — one, which is cal- 
culated to ameliorate the condition of any class, over whom 
they have control. And, this example is not lost, when we 
come to the lower* and less important subdivisions c-f our 
§ overnment. The executive power of a county, is con- 
stantly engaged in doing good, and so it may be said of our 
townships. We build palaces; for our poor, furnish them 
with fertile acres, from which, they can raise their bread, 
and failing in this, make ; up their deficiencies, from the pub- 
lic purse. We make the prison a mere place for absenteeism 
from the world. Dungeons and chains, are among the 
things that once were, unless some refractory delinquent 
should so lose sight of his own true interest, as to court ex- 
traordinary punishment, by perverseness of behavior. The 
Unfortunate are treated with humanity, are clothed, fed, and 
eventually discharged, men and women as before, and not 
degraded to the level of the brute. Criminals, are recogniz- 
ed as human beings, have their wants ministered unto with 
assiduity, and forfeit no claim to the rights of man, until the 
law seizes them as its legitimate victims. Public sentiment 
regulates these things, and it would be as surprising to find 
one in authority, exercising tyrannical sway, over those, 
whose misfortunes had brought them to the Aims-House, or 
those, whose irregularities had consigned them to the walls 
of a prison, as it would have been years ago, to find senti- 
ments of real humanity prevailing in the official mind. A 
storm of indignation, would be poured out upon him, who, 
forgetting the claims of his fellow-men, would take advan- 
tage of their depressed condition, and treat them with bar 



116 DR. SAUNDERS ? S ADDRESS. 

barity. The finger of scorn, would be levelled at him with 
unerring certainty, and the withering blight of an odious 
name, would be fastened upon him, at once. Scarcely any 
one, would have the moral courage to brave public opinion, 
to such an extent, as to be guilty of positive acts of arbitrary 
violence, and no one would be tolerated, who was notori- 
ously cruel and vindictive. The heart of the American 
public, is in the right place. In the plenitude of the favors, 
which it has pleased an all-wise Providence, to shower upon 
us as a people, we have still remembered, that we have a 
duty to perform towards our fellows in adversity — -and, it 
would almost seem, that in propotion to the benefits confer- 
red, were our endeavors to be actively engaged in works of 
philanthropy. 

But, the noblest impulse which has stirred the American 
heart, is that, which has raised up in many of the states of 
this Union, magnificent structures, for the reception of those 
who are bereft of reason. In the olden time, and in other 
lands, spacious castles, with their long ranges of rooms, were 
erected only for the accommodation of the man of noble 
blood, his family, friends and retainers — but now, in this 
country particularly, should you see a massive range of 
walls, pierced for an hundred windows, crowned with all 
the evidences of a strict architectural taste, the whole thrown 
together, in accordance with a style of building, which has 
graced some anterior period of history, and situated, perhaps, 
on a commanding height, with beautiful lawns and well ar- 
ranged shrubbery in front, a dense primitive forest in the 
rear, and large cultivated fields all around — a thousand 
chances to one are there, that it is intended for the reception 
®f those who suffer from a disordered intellect, and is called 
a Lunatic Asylum. For its erection, the sovereign people 
have given of their substance — for its maintenance, they 
contribute, cheerfully, whenever it is necessary. They look 
upon it with that kind of satisfaction, incident to an act of 
well-doing, and regard it as a secure place of refuge, should 



DR. SAUNDEltS*S ADDRESS* 117 

it be so ordered, in the course of humali events, that the 
hand of the smiter should be laid heavily upon them — that 
the balance wheel of the mind should give way, and the 
whole of the intellectual organism, should be surrendered up 
to riot and confusion. Splendid charities, are these Asy- 
lums, and destined to go down to posterity, marking an 
eventful period, in the history of the civilized world ! They 
will indicate to coming generations, the time, when the pub- 
lic mind had become so far humanized, as to adopt rational 
modes of treatment, for the restoration of the wandering in- 
tellect. Those who come after us, and who are living in a 
state of advancement, which we of the present day should 
consider, little short of that which precedes the millenium, 
may experience a satisfaction, in knowing the period and 
under what auspices, we emerged from comparative barbar- 
ism. Our hospitals, asylums, prisons, and institutions, for 
the general diffusion of knowledge, will be looked to, and, 
from the history of these, the question will be definitely set- 
tled. We have a direct interest then, in maintaining the re- 
putation of the age in which we live, for deeds of true be- 
nevolence, beyond that of the more transitory gratification, 
which the practice of the virtue affords. 

To the honor, of the true disciples of medicine, be it said, 
that almost to a man, they have raised the voice of encou- 
ragement, in favor of the establishment of Lunatic Asylums, 
by state authority. Bound by no narrow notions of policy, 
they have taken a fair view of the ground, and generally 
have been foremost, in meeting the objections urged by 
those, whose slight acquaintance, with the objects to be se- 
cured, had led them into opposition, they scarcely knew 
why. In every neighborhood, the intelligent practitioner of 
medicine, has an influence almost unbounded upon certain 
points. Should a question be raised, which involves the 
sanitary condition of his locality, or which concerns the phy- 
sical well-being of certain classes of the community, all eyes 
are instantly turned to the one, who has resolved their dinl- 



118 dr. saunders's address. 

culties of that character, for the last half century ; or, to him, 
who has lately assumed the mantle of the elder, and who 
wears it gracefully, and confidently. From the decision, 
there is no appeal. When uttered, its mark is left upon the 
public mind, never to be obliterated. No autocrat, exer- 
cises a more absolute power, than a physician, in the line of 
his profession, if he has the entire confidence of the people, 
among whom he lives and moves — and, it is well that such 
is the case, else, very often, strange conclusions would be 
arrived at, and no less strange would, be the thoughts, and 
actions of the multitude, on subjects, of which, generally, 
they are not acquainted with the single principle involved. 
The diffusion of correct views, respecting Lunatic Asylums, 
is to be ascribed chiefly to physicians. They have stood up 
fairly, as the body-guard of the policy, which dictated their 
creation, have earnestly advocated them, on the plea of obe- 
dience to the ordinary dictates of humanity, and, have al- 
ways considered their presence, as one of the evidences of 
more enlightened sentiments, prevailing throughout the 
world, regarding the basis, upon which our noble profession 
rests. It becomes our duty then, having advanced thus far, 
to sustain them promptly, and not to suffer them to droop, 
and languish for want of sufficient encouragement. A plain 
duty, I conceive it to be, so long as the management may be 
considered as irreproachable — in other words, so long as 
they are under the government of educated men, who ad- 
here strictly to the well established platform, upon which 
medicine is founded, and who are not running hither and 
thither, after every new fangled invention. 

In New Jersey, we have an institution, large and commo- 
dious. It is by far, more extensive, than any other build- 
ing in the state, and embodies every improvement, which 
the practice of modern times, has brought into vogue. It is 
in its infancy, it is true, and has not, as yet, its rooms crowd- 
ed with occupants. Under the present form of government, 
it will take time to fill it completely. The superintendent 



DR. SAUNDERs's ADDRESS. 119 

is a man of acknowledged ability — all that a votary of our 
science could desire. His appointment, was not in entire 
accordance with the wishes of the profession throughout the 
state, for it was thought by many, that there was little need 
of stepping beyond our territorial limits to find one possessing* 
all the requisite qualifications for the post — and, I am wil- 
ling to admit, that it was not pleasant to me, to see our pro- 
minent practitioners passed by, as though it was totally im- 
practicable, to select from among them, one competent to 
perform the duties of the station. But this, is a matter of 
small import, when we take into consideration, the great ob- 
jects, which such an establishment is designed to' secure. — * 
We should not suffer the general good to be impaired by an 
opposition,' founded upon a principle so selfish, as that of 
wounded professional pride. Such a course, would! be un- 
>wise, and at the same time, unjust to the individual, who 1 
has been called to preside over, and guard the interests of 
the Asylum. 

It is to be feared, that the time is approaching, when a- 
spirit of demagogueism, will endeavor to scatter the seeds" 
abroad, of a feeling, somewhat hostile to the free develop- 
ment of all that is needful, to sustain the institution. It has 
become too much the practice in our country, to give a wil- 
ling ear to every thing, that is uttered against the manage- 
ment of large establishments, which derive their sustenance 
from pecuniary aid, furnished by the people— and, there are 
individuals always ready to foster this feeling, in order to ad- 
vance some private interest. I should not be surprised, at 
any time, to kijiow that a systematic attack was contempla- 
ted against our Lunatic Asylum, in order to give vent to the 
spleen of some one of the political parties, notwithstanding 
the feeling has been so general, among the people at large, 
in favor of its erection. The benefits to be derived from it, 
probably will not be denied, but the manner of conducting 
it will be assailed, and an attempt will be made to embar- 
rass its proper working. Political parties, are not apt to be 



120 dr. saunders's address. 

scrupulous, respecting such matters. It would be well, for 
the medical profession, to be ready at all times, to repel any- 
unreasonable assaults — to stand up manfully, and roll back 
any reactionary feeling, that may be produced by motives, 
originating in a source so impure. The germ of opposition, 
I think, has been laid in a neighboring county.* The proper 
authorities, have appropriated the means, to erect an Asylum, 
in connection with the Alms-House, and, in justification, 
say, that it will save a vast sum of money yearly, and will 
be amply sufficient for the accommodation of incurable pa- 
tients. This may be right, but the idea will suggest itself that 
probably the movement may have been dictated by a lurk- 
ing hostility, to the institution established by the state. It may 
be remembered, that nearly all our buildings, for the accom- 
modation of paupers, have had the usual appendage of a mad- 
house. In these, the lunatic poor, were confmed-^and, to 
remedy the evils, which they engendered, was one of the 
prominent reasons, for erecting an edifice, at the expense of 
the state, and placing it under the charge of one> well ac- 
quainted with the treatment of the insane, and who would 
devote his entire attention to it. Proper care, cannot be ex- 
ercised, and proper influences of a moral character, cannot 
be brought to bear, upon the unfortunate victims of insani- 
ty, in a mere county mad-house — the thing is impossible, un- 
less the Steward is a man of greater intellectual capacity, 
than those who are generally selected. Asylums for the in- 
sane, may be constructed with propriety, in every county of 
the state, provided, they are made essentially, what they 
purport to be — but, a warning voice should be raised, against 
making them mere depositories of the afflicted, in order to 
secure a saving of a few dollars to the county treasury. 

A word, now in conclusion. As I have before remarked, 
our profession exercises a commanding influence, over the 
masses of the people, in matters of this kind. Should phy- 
sicians generally take the stand, that the interference of 

♦Burlington. 



DR. PARRISH'S ADDRESS. 121 

demagogues should be resisted to the death, and that it 
would be right, that it would be humane, to encourage the 
state institution, to the exclusion of all others, unless con- 
ducted upon similar principles; then we should have eventu- 
ally, after a full trial had been secured, a quiet and well-or- 
dered retreat, where the diseased mind could be restored to 
its original tone, if the nature of the case admitted of a cure. 
A responsibility rests upon us as a class, and this subject 
should receive the serious consideration of every member of 
our fraternity, throughout the state of New Jersey. 



BURLINGTON COUNTY MEDICAL SOCIETY. 

THE INFLUENCE OF THE UTERUS, ON THE FEMALE CONSTITUTION. 

Jin Address, delivered be/ore the Burlington County 
Medical Society, Oct. 16, 1849. By Joseph Parrish, M. D. 
\ — Printed by order of the Society. 

Members of the Medical Society,— The assembling of our- 
selves together on this occasion, offers a fit opportunity for 
the discharge of an obligation, which, by your appointment 
is due at my hands ; and in attempting to redeem it, you 
will allow me to read a rather discursive essay on the in- 
fluence of the uterus on the female constitution; the distinc- 
tive peculiarities of which, taken together with the fact 
of its greater susceptibility to morbid impressions, renders 
the subject one of unusual interest. Although the human 
female possesses a finer frame, and a more delicate organ- 
ization than man, she is liable to a greater variety of disor- 
ders, dependent in considerable measure upon mere sexual 
formation, and is required by the unalterable laws of na- 
ture, to endure more real suffering in a condition of health, 
than falls to the lot of the stronger sex under the effects of 
even painful, and protracted disease. The lengthened pro- 
cess of gestation alone, with its multiform developments of 
sympathetic affections, elaborates a series of changes in the 
habits of her constitution, to endure which the physical en* 

ergies of the strongest man would seem totally unequal,*^ 
16 



122 DR. PARRISH ? S ADDRESS. 

and even before she becomes fitted for the performance of 
the gestative function— while yet in the years* of childhood^ 
she may be visited with some affliction peculiar to her kindj 
— at that period also, when she emerges from the budding 
of youth, to the bloom of early womanhood, she h surround- 
ed with dangers, and looks forward with fearful anticipa- 
tions, which none but those who have realized them can 
comprehend. If nature be at all in fault, her danger is 
greatly increased. If she be prematurely visited with a co- 
pious menstrual flow, the vital forces sink below the stand- 
ard of perfect health ; or if the menstrual period be pro- 
tracted beyond the time for its approach under ordinary cir- 
cumstances, the system becomes disordered with a variety 
of symptoms, which may exhibit themselves in a greater or 
lesser degree of violence, as there may be more or less ine- 
quality in the nervous and sanguine temperaments. To en- 
quire into the pathology and treatment of some of these af- 
fections, shall be my chief object on this occasion; and with- 
out attempting to- support any of the various theories which 
have obtained from time to time, with reference to- the mo- 
dus -operandi of the sympathetic relations which exist be- 
tween the uterus, and other parts of the body, I propose 
simply to offer the result of my own experience, and leave 
you, gentlemen, to form your own conclusions, as to how 
much attention ought to be paid to the uterine functions, 
when treating even ordinary diseases, which arc not de- 
pendent upon sexual peculiarities. Having the medical su- 
pervision of a family of females, numbering on an average, 
one hundred and fifty individuals, most of whom are be- 
tween the ages of twelve and seventeen years, I have en- 
joyed some opportunity of observation upon this subject. 

They occupy the same building, partake of a common 
diet, and are engaged when in health, in the prosecution of 
studies, beginning with the elementary branches of an En- 
glish education, and rising to the higher pursuits of mathe- 
matics, the languages, drawing, music, &c. &c» I propose 



DE. ¥ARRISH*S ADDRESS. 12S 

to show that most of the diseases that I have been called 
upon to treat in these young persons, and those of the same 
class, who come under daily observation in private practice, 
owe their origin to uterine derangement. Hysteria, 
temoptysis, asthma, coughs, head-aches, pains in the breast, 
and other ordinary, and some anomalous affections, may be 
generally traced to irregularity -or .deficiency in the uterine 
function. While there can be no doubt that these diseases 
occur in young women, with perfect menstrual develop- 
ment, experience teaches that in the majority of instances 
they are dependent upon the generative system; because, 
with a restoration or regulation of the menses, the diseases 
become either greatly modified, or entirely disappear ; and 
where it -is beyond the power of our aa:t, to restore the natu- 
ral uterine action, they continue without relief. Two of the 
inmates of this family, each about seventeen years of age, 
from widely distant sections of the country, and with very 
different early habits, both of them possessing highly culti- 
vated minds, and apparently in the enjoyment of perfect 
health, have been subject to attaeks of asthma, which oe- 
eurred at the menstrual period^ and as this period with 
each, arrived nearly at the same time, the affection appeared 
simultaneously in both $ — for several months these patients 
were brought to the infirmary at stated intervals, and placed 
lander my care. It was found, that they were menstruating 
with difficult!/ at the time of the attack, that the asth- 
ma was sympathetic of dysmenorrhea ; and that with the 
entire subsidence of the catamenial flow, the asthmatic 
symptoms disappeared. The treatment of the paroxysms 
consisted of hot mustard pediluvia?, hip baths, assafqstida 
enemata, dry cups to the spine, free purgation, &c. &c.,— - 
and between the attacks, a tonic plan of treatment was en- 
joined, with exercise, bathing, and other hygienic remedies, 
calculated to establish the vigor of the uterine function. Un- 
der this course of management, they menstruated freely, reco- 
vered from the asthma, and enjoyed general good health af- 



124 BR. parrish's ADDRESS. 

terwards. Three others, all from the south, were attached 
with chorea, which continued obstinate while the uterine 
action remained deficient, the ferruginous and aloetic treat- 
ment was adopted in each case, with quinine and assafceti-* 
da, &c. Under this treatment, the matrix began bye and 
bye, to yield the catamenial secretion copiously, the mus-* 
cular contortions subsided, and the patients recovered rapid- 
ly. That the chorea in these cases, was entirely depen- 
dent upon the languid condition of the uterus, I do not pre« 
tend to say, but that it was ungovernable till the menstrual 
discharge was fairly established, seems to prove that nature^ 
aided as she was, by supporting and soothing medication, 
was unable to accomplish the cure, till the womb responded 
to the remedies employed, and supplied in sufficient abun- 
dance its natural secretion. In private practice, several 
instances corroborative of this fact, have come under my 
observation ; and one lamentable case occurred, where the 
uterus failed to act, and the patient died. This poor girl 
had never fairly menstruated, a slight show having appear? 
ed only once or twice. Her case presented the characteris- 
tic signs of chorea, in the most aggravated form that I ever 
beheld them ; she was in very humble life, and deprived of 
many advantages that are within the reach of others better 
circumstanced, and the early part of her sickness was neg- 
lected, owing to the fact that the contortions of her face and 
limbs were attributed to habit ; so that scolding and ridicule 
took the place of proper remedial measures, in order to cure 
her. Iron and aloes, hip baths, mustard to the lumbar re- 
gion, a blister over the cervical vertebrae, musk, cimicifuga, 
shower bath, &c. &c. &c, were all tried without success. I 
believed then, and am still of the opinion, that had she been 
in a situation where she couldj have received the attention 
that is necessary in such cases, the uterine action might have 
been established, and that she would have recovered. There 
is no disease however, more dependent upon the sexual sys- 
tem than hysteria, and I use the terra here in the limited 



Dr. parrish's address. [125 



sense in which it is generally received, though always as- 
sociating it in my mind, with whatever symptoms may pre- 
sent themselves, that can be traced to uterine sympathy. — 
And I will now attempt to describe two highly interesting 
cases of hysteria, and the treatment pursued in each of them. 
One, is a young girl of sixteen, tall, with well developed 
muscular system, light hair, ruddy complexion, and of gene- 
ral healthy appearance. Her mother sought my advice to 
relieve her convulsions. It was stated that many years ago 
she had a fall from a hay-mow and injured the skull, so as 
to render a surgical operation necessary, — the nature of the 
operation was unknown ; her convulsions were hence at- 
tributed by her parents, to some injury of the head received 
at that time. When attacked by them, her struggles were 
violent, and her screams terrific, she would suddenly rise 
from her chair, run into the yard or street crying for help, 
and fall in a fit. Her temper was exceedingly irritable: — at 
times she refused to work, and was even violent m] language 
and gesture towards her nearest friends. The case excited 
a great deal of interest in the neighborhood, some thought 
a piece of bone was in her brain, others supposed her to 
have a tape worm, as her appetite was extremely variable, 
and at times unnatural ; others again called her disease epi- 
lepsy, while some said that it was the effect of changes in 
the moon, as her attacks were periodical. So that the poor 
girl and her parents were driven almost frantic by the 
doubts, and fears, and hopes, that alternately took possession 
of their minds. Being told that time, and faithful perseve- 
rance in the application of remedies, would be necessary to 
ensure a fair prospect of her recovery, they thought to be 
gratified by an immediate cure, and the so-called science of 
psycology was brought to her aid ; but its magic touch 
could not relieve, or even improve her, and, her parents 
finally agreed to submit to medical treatment. Upon enquiry 
about her catamenia, it was found that their return was re- 
gular, but the quantity was deficient, and the evacuation at- 



126 dr. parrish's ADDRESS. 

tended with pain. She was recommended to take exercise 
freely in the open air, employ herself regularly with active 
household duties, and use the iron and aloetic preparations 
as they might be prescribed from time to time — this system 
was adopted, and carefully executed. In less than three 
months, she recovered entirely under the use of the Pilulae : 
Ferri : Carbonatis, the menstrual flow being fully esta- 
blished, and all things doing well. 

The other is an intelligent young woman, of about 
twenty years of age, who from some impropriety, became 
irregular in the performance of her menstrual function. 
When she came under my care, I found her muscles 
soft and undeveloped, the circulation rather feeble, particu- 
larly in the cutaneous capillaries, and the uterine show 
very irregular in its appearance, and deficient in quantity; 
her temperament lymphatic, though with a well cultivated 
and naturally acute intelligence. Soon after the uterine ir- 
regularity was discovered, she became the victim of facial 
and temporal neuralgia, sometimes hemicrania, and some- 
times clavus-hystericus were present. These attacks came 
on whenever the nervous system was disturbed by any sud- 
den impression, whether of fright, joy, or any other strong 
emotion: though they were more violent at the menstrual 
period ; the catemenia were never present more than two 
days, — oftener twenty-four hours, and frequently a less pe- 
riod of time was the extent of their existence. In this case 
a rigid system of hygienic treatment seemed to promise the 
most good. It was recommended in conjunction with the 
carbonate of iron, and other tonic remedies ; during the 
paroxysms, assafcetida enemata, hip baths, and pediluviae, 
with chloroform as a local anasthetic, and by inhalation, 
afforded the most relief. The carbonate of iron seemed af- 
ter a while to irritate the stomach, and the citrate of iron 
and quinine was substituted — they were all faithfully tried, 
as was quinine in large doses during the intermissions, with- 
out any apparent good result. Under its use however, the 



dr. parrish's address. 1^7 

Cervical portion of the spine became the seat of acute painy 
and the region under the left clavicle — which alternated 
strangely between these two localities, till it spent itself there/ 
and performed a metastatic route to the diaphragm ; — here 
all the symptoms of impending suffocation, hiccough, &c. be- 
came manifest in turn, and the patient^ wearied with conti- 
nued suffering, became languid in spirits, and began to as- 
sume a cachectic appearance. She was then put under the 
Use of black hellebore, in conjunction With the carbonate 
of iron. She continued this for several weeks without any 
evidence of its emmenagogue properties. The trunk of the 
body became relieved and her neuralgia returned, during a 
violent paroxysm of which, she suddenly fell asleep, as if 
from exhaustion — her slumber was gentle as" an infant — arid 
after an hour or two of repose, she roused suddenly, and fell 
into 5 a condition resembling hemiphlegia, her head was in- 
clined to the left side, her eyes staring and fixed upon the 
wall, and the extremities of the left side apparently paralyz- 
ed. She was] not sensible of ordinary friction upon the af- 
fected part, though she could readily feel the sharp prick of 
a pin, or the pinching of the skin between the fingers. It 
was quite difficult to rouse her, but when once disturbed', 
though naturally a sweet tempered and amiable person, she 
was irritable, and abrupt in conversation and manner. 
Friction over the extremities was resorted to, until warmth 
was restored to the' surface, though she continued in this 
condition for about twelve hours. It terminated in a parox- 
ysm of crying, and she continued much better for several 
days. She had no recollection of what was being said or 
done around her. Again, the pectoral muscles and dia- 
phragm became the seat of convulsion, and she appeared to 
suffer almost beyond the power of endurance with violent 
asthmatic symptoms, which seemed continually to threaten 
suffocation. The inhalation of chloroform or ether, or both 
combined could not be borne, and though it acted so readily 
in affording relief from the neuralgic pains, it appeared to 



128 dr. parrish's address; 

aggravate the dyspnoea, whenever it was presented. Dry 
cupping to the spine, pediluviae, sinapisms, anodyne injec- 
tions, &c. were freely resorted to during the attacks, the 
pulse was always feeble and rapid, the skin cool and pale ; 
—the lancet was entirely inadmissable. Finally she was* 
placed under the use of the dried sulphate of iron, rhubarb,' 
and aloes in combination, and to the gratification of all 
concerned, the deathlike paleness and coolness of the skin 
began to disappear; in less than a fortnight the lips assumed 
a more cherry hue, and the muscles became more firm, so 
that she was able to leave r her apartment, and join in the do- 
mestic circle. But the chapter of hysterical vagaries is not 
yet complete — croup being suddenly imitated in all its vio- 
lence. I was sent for, and found my patient gasping for 
breath, — the chest heaving in convulsive efforts to fill the 
lungs, the characteristic sound Was distinct, the arms were 
thrown out as by sudden spasm, the recumbent posture ivas 
intolerable, and the patient cried for help. All this time the 
pulse was feeble, the skin cool, and there was no evidence 
of inflammatory action — anodynes, and Ideal stimulants 
relieved her; and after a while pertussis was ushered in 
as a modification of the former attack ; this was also sub- 
dued by the various remedies before used, with the ad- 
dition of a towel wet with cold water to the throat— the im- 
pression thus conveyed to the part contributed greatly to re- 
lieve the spasm, and the patient fell into a gentle sleep. In 
the intermission, the sulphate of iron was continued, and the 
general health began to improve — it was evident that the 
red corpuscles were supplied in greater abundance, the pulse 
gained in volume, the flesh grew firmer, the cachectic ap- 
pearance gradually gave place to a more ruddy hue, and 
hopes began to brighten that she would soon menstruate 
freely, and be restored to health.* 

*Soon after this, she removed to a more southern clime to spend the 
winter, where, with a faithful continuance of the feruginous treatment, she 
has greatly improved. Letters are frequently received, informing me of 
her constant progress toward complete recovery. 



dr. parrish's address, 129 

Several cases of haemoptysis, accompanied "with cough, 
and dull sound upon percussion, have been treated on the 
same plan, in which, when the catamenia appeared under 
the use of aloes and iron, the engorgement of the pulmonary 
vessels ceased, the blood flowed freely into the capillaries, 
the physical signs announced a free admission of oxygen 
into the air ceils, and the vital fluid being improved in 
quality, — confirmed good health was the result. Epistaxis 
appearing to an alarming extent in one instance, was re- 
lieved by the same remedies: and a variety of other diseases 
— -which, when they occur among men, are treated by the 
lancet and anti-phlogistic medicines, — have been relieved by 
imparting tone to the circulation, and increasing the vitality 
of the blood ; so that the evidence in favor of tonic and sup- 
porting medication and diet, in most of the diseases of young 
women with enfeebled menstrual powers, appears to be 
conclusive. 

We have seen, by the examples already cited, that he- 
morrhages, though often treated on the principle of diverting 
the blood from the part affected, by a reduction of its vo- 
lume, which may be judicious practice, in extra-sanguine 
constitutions, have been subdued by a directly opposite 
course. Convulsions also, for which the lancet has been 
considered, and still is by many, an essential, and sovereign 
remedy, are cured by medicines, the specific operation of 
which is to give tone to the circulatory system, and improve 
the character of the vital fluid. Certainly we cannot doubt 
the controlling power of the uterus over the constitution, 
and I am sure we cannot be too careful in our enquiries 
about the menstrual function, in all cases of disease occur- 
ring in females, and particulary in those under age. Had 
the persons above referred to, been depleted by the lancet, 
or powerful antiphlogistic medicines, though they exhibited 
symptoms of congestion, and suffered acute pain, they 
would in all probability, have been made the hopeless vic- 
tims of incurable disease, and brought to a premature death. 
17 



130 DR. PARRISH*S ADDRESS. 

It may seem presumptuous to speak with so much certainty 
upon a subject involving the preservation of human life, 
the issue of which is not in human hands ; but if there is 
any truth in science, or any evidence to be derived from ex- 
perience, there is power in medicine when properly applied, 
to overcome the assaults of disease, with but comparatively 
few exceptions. Our greatest danger is in diagnosis ; a mis- 
take made in this respect may lead to fatal results. Hence 
it is of the utmost importance to discriminate between real 
or organic disease, and a mere disturbance or perversion of 
natural functions. Nothing is easier under such circum- 
stances, than to fix by what is called heroic practice, a 
structural malady, upon a part only disordered in function ; 
when by a course calculated to calm excited nervous ac- 
tion, to soothe the irregular movements of the heart, and to 
quiet the general economy by moderating remedies, while 
we strengthen the vital forces, and guard the nervous cen- 
tres from increased disturbance, we may ward off alarming 
and fatal diseaes, that would be readily invited and estab- 
lished by a different mode of treatment. Where we see 
hysterical convulsions, or hysteria in any form, we are re- 
minded by the very name of its sympathies,and connections 
with the generative system. To bleed in convulsions, with- 
out reference to their character or cause, is adopted by many 
even at this day; very young children are sometimes sub- 
jected to the lancet by this arbitrary rule, and though de- 
pletion by this means may in some cases be called for, 
we are satisfied that a candid enquiry into the pathology 
of the parts involved, will not justify us in the ge- 
neral adoption of the remedy. It was the opinion of Dr. 
Marshall Hall that all convulsive diseases have their origin 
in the spinal chord, and though in the present state of patho- 
logical research, it may be difficult to give a systematic ac- 
count of the changes which occur in the nervous structure, 
during convulsions, enough has been learned by expe- 
rience, arid inferred from analogy, to warrant the physician 



t)R. parrish's address. 1^1 

in attributing to nervous origin, many diseases which have 
been formerly considered and treated as inflammatory. The 
effects of a mechanical division of the nerves, or of injury 
to the substance of the spinal chord, are familiar to all; hence 
we readily infer from these results, that when disease attacks 
the nervous centres, we may have it displayed in various 
forms, modified by the seat or extent of the lesion ; and as 
the object of the nervous mass within the spinal column, 
is to send out supplies of motive and sentient power to 
different parts of the body, it is reasonable to assign 
those diseases, which affect the motions and sensations, to 
the same source, and to address our remedies particularly to 
the seat of the mischief. We often see convulsions brought 
on by a sudden mental impression — the whole nervous sys- 
tem sympathises with the excited brain, and involuntary 
contractions and relaxations of the muscles alternate with 
each other, constituting spasm or convulsion. The physi- 
cian is called in haste to administer relief; he finds his pa- 
tient writhing under violent contortions of the body, her eye- 
lids closed and trembling, the balls thrown back into the 
orbit, and other characteristics of hysterical spasm. If he 
bleeds, he may probably afford sudden relief; but what 
has he done to remove the cause ? True, the remedy 
ma}r remove the engorgement of some important ves- 
sels, but that engorgement in such cases, depends upon im- 
paired nervous energy, by which the check upon the arterial 
system is withheld, and the equilibrium between it, and the 
nervous system destroyed. The pulse does not indicate inor- 
dinate vascular action, and though the head may be hot, and 
the face suffused, the feet and hands are generally cold, and 
often livid. There is not too much blood in the body, but 
it is unequally distributed. If you take a portion of it away, 
you create a second evil, where there existed only one. 
You reduce the energy of the circulatory system, which, ad- 
ded to nervous irregularity, complicates the case, and ren- 
ders the cure more difficult. The two forces should be 



132 db. parrish's address. 

equipotent, to sustain an equal relation to each other ; and 
if one becomes reduced below the normal standard, it does 
not seem in accordance with true philosophy or science, to 
reduce the other likewise, in order to maintain them both 
at the poiut of perfect health ; but to elevate the one to its 
natural condition, the very effort to do which will subdue 
the excitement of the other, and thus restore their mutual 
relations. But after all that may be said of medical treat- 
ment, physicians can do more permanent good to society, by 
inculcating correct rules in regard to physical education, and 
by insisting upon their observance in families over which 
they exercise medical control, than by any effort to find out 
remedies for the disease when once established; as it is 
much easier to prevent, than to cure, this obstinate malady. 
The habits of what is called refined society, bestow 
upon those who observe them, a large share of physical dis- 
order ; and just in proportion as the individual maybe eon- 
trolled by the false lessons they inculcate, does a perversion 
of the moral feelings, and a deterioration of the intellectual 
vigor, ensue. In the education of youth, both at home and 
at school, too little regard is paid to the development of the 
physical system. Parents and teachers are far too ready to 
overlook the fact, that a perfect mental constitution depends 
upon a perfect physical organization ; they seem to forget 
that in their efforts to cultivate the intelligence, and 
strengthen the mental powers, there are more than four hun- 
dred muscles, a heart, lungs, a liver, a stomach, a uterus, 
and other viscera, each of which has its appropriate office 
in the physical system; and that upon the improvement, and 
development of these, depends the improvement and deve- 
lopment of the intellect; that if they would preserve the health, 
prolong the life, and render useful and practical, the acquire- 
ments that may be obtained, the growth of the mind must 
not be allowed to outstrip the growth of the body. With 
children of the female sex, this is more particularly true. 
The manner in which young girls are made to dress, is of 



dr. parrish's address. 133 

itself, sufficient to entail upon the sex, the evils of an une- 
qual temperament, feeble digestive organs, undeveloped ute- 
rine powers, and a general depravity of the physical condi- 
tion. The under garments are drawn tightly around the 
waist, — they must be tight in order to retain them in their 
position, &nd they are fastened with small tapes or chords — 
these strings pass over the region of important viscera, and 
the integuments are pressed inwards upon them, with a 
force sufficient to interrupt at least the cutaneous circula- 
tion, while the weight of the clothing is constantly bearing 
down all the contents of the' abdomen, upon the bladder 
and uterus, in the pelvis below. The powers of the stomach? 
are over-taxed with unwholesome and indigestible foodjthe 1 
ready assimilation of which is prevented, and an imperfectly' 
organized fluid, is thrown into the venous system. The 
chest is too often compressed, and the thoracic organs de- 
prived of their full play? so that the heart labours to supply 
the lungs, and they in turn, are scarcely able to receive a 
sufficient quantity of oxygen to vitalize the blood* With* 
such restraints upon the natural powers of the body? 
is it any marvel that the uterus fails to elaborate its secre- 
tions, or that when they do appear, they should be deficient 
in quantity, or in the qualities of a healthy discharge? Or is 
it difficult to understand how the great sympathetic system*, 
conveys the morbid impression to the spinal chord, which 
sends back a reflex movement that is answered by muscu- 
lar contortions and convulsion ? 

Whenever a hysterical, or otherwise delicate girl, is sub- 
mitted to me for treatment, whether she be suffering from 
pains in the head, breast, or joints, or whether she have 
ammenorrhea, or dysmenorrhea, or if she has never menstru- 
ated at all ; my advice to her is, to wear flannel next to 
her body, to put straps or jackets to her under clothing, so 
that no undue pressure will be made upon her waist, and 
that she may avoid the weight of from ten to twenty pounds 
upon her loins, to the great detriment of her digestive, and 



134 DR. PARRISITS ADDRESS, 

uterine organs; as well as to prevent all compression upon her 
pectoral or spinal muscles, by which the motions of her up- 
per extremities may be restrained. Having been relieved 
6f all unnatural and injurious appliances, her heart may 
have room to pulsate, her lurigs to expand, and her abdo- 
minal and pelvic viscera, to perform their functions. With 
such preparatory measures, the system will more readily re- 
spond to the remedies that may be administered, and the 
physician be enabled to promise at least some good. 

The present system of education, common in our schools, 
and seminaries, is generally charged by the popular voice, 
with injuring the health of -pupils; and the remark has~ofteh 
been made that boarding-schools for girls, are good manu- 
factories for uterine and hysterical complaints. The cfuesk 
tion is not unfrequently asked, whether a derangement o'f 
the menstrual function, is not the prominent feature of dis- 
ease in the institution, to which reference has been made— 
while candor compels an admission of the fact, the convic- 
tion that a deficiency of physical education at home, is the 
primary and the chief cause of it, is equally manifest. Pa- 
rents send their daughters away from home, to complete an 
accomplished education, just at that period of their lives, 
when the generative system is beginning to be developed, 
when the sensations, and sympathies of the uterus, are the 
most delicate, and most likely to be disturbed ; and if in the 
bourse of study to which thay may be subjected, their health 
fails, or becomes in the least impaired, how much more easy 
is it to attribute the decline of their physical powers, to ex- 
cessive mental application, than to the fact that parents them- 
selves have not trained their children in accordance with 
those physiological laws which nature has established, and 
a departure from which, is in all cases, visited by the penal- 
ty of ill health. It was never intended that the body should 
succumb to any reasonable amount of mental effort, but when 
it does, it may generally be attributed to the imposition of ar- 
tificial restraints in early youth. A high rank of intellectual 



dr. parrish's address. 135 

culture, cannot be gained, without the expenditure of a great 
amount of both mental and physical strength; to supply the 
means of making this effort, the bodily health must be fully 
sustained ; the mind breaks the body down, because the lat- 
ter is not allowed to be early developed to its perfect pro- 
portions, it is crippled in its capacity for endurance, by the 
habits imposed upon it by the oppressive regulations of fa- 
shionable life. If the physical education of children, was 
conducted according to the dictates of sound philosophy 
and science, nature would be allowed to develope herself, 
and would furnish abundant resources to meet all the de- 
mands of the most exalted mental culture. To establish 
rules for the bodily training of children, and to render them 
practical, is a high prerogative, which belongs peculiarly to 
members of the medical profession ; an.d for its conscientious 
exercise, we are justly responsible. To perform it faithful- 
ly, would be to save ourselves a great deal of anxiety and 
labour, confer a permanent benefit upon society — and reflect 
lasting honor upon our beloved profession. 



BIBLIOGIUPIIICAL NOTICES. 



The Present Position of the Medical Profession in Society 
— Jin Introductory Lecture, delivered in the Medical 
College of Georgia, Nov. 5, 1849. By Paul T. Eve, 
M. D., Professor of Surgery, Editor of Southern Me- 
dical and Surgical Journal, one of the late Vice Presi- 
dents of American Medical Association. Published by 
the class. 

The subject of this address is treated of under five dis- 
tinct heads — each of which has an intimate relation to the 
other, while the whole forms a candid and truthful picture of 
the present position of our profession in its relation to public 
opinion. The causes of prejudice against us are attributed — 
first, to the want of harmony among its advocates, secondly, 
to the fact that the errors of all who administer physic are 
charged to the physician: thirdly, that it is judged of by those 
unqualified to form a correct opinion : fourthly, to the fact 
that so little has been done for the profession by the public, 
while patents are granted to quacks for secret medicines, 
and charters allowed for Colleges to teach empiricism: and 
fifthly, to the truth, by all admitted that medicine is the most 
difficult, obscure, and complicated of all human learning. 
We give below, the concluding remarks. 

"But, gentlemen, notwithstanding the positions assumed in 
this lecture, medicine as a science is steadily advancing. In 
any vindication of the profession before the people, justice 
should always be tempered with mercy, since on this subject 
they know not what they do ; however they may act, they 
never reason on it. Though tossed by every wind of doc- 
trine, and lending a willing ear to every theory connected 
with the healing art, still the community know they can de- 
pend alone upon the regularly educated physician. We 
have much and satisfactory evidence on this point. Hospi- 
tals of all descriptions are alone confided to members of our 
profession ; they alone treat the insane ; they alone are ever 



»B. EVE*S LECTURE* 1ST 

invited to become co-workers with the ministers of the gos* 
pel in missionary fields. In courts of justice, the evidence 
of a physician on a medical subject Will out-weigh all other" 
testimony — it is alone to be relied upon. A hundred and 
fifty years ago, one in every twenty-three of the inhabitants 
of London died, now there are not more than one in forty. 
In the United States army, including all cases, less than one 
in every two hundred die. The average mortality in civil 
practice has been calculated at six per centum, and this, it 
must be recollected, is among patients whom domestic re- 
medies or nostrums have failed to relieve, for we are not 
now the first called to a case of sickness. A French Jour- 
nal of medicine states that, during the prevalence of cholera 
in Russia, a religious sect refused all medication ; the num- 
ber of deaths among them about equalled the number of 
cases; while among other patients, at the same time and 
place, put under treatment, only from thirty-six to sixty-two 
in every hundred died. In Paris, it was found that the ratio 
of mortality from this epidemic was less, in the military than 
in the civil hospitals, which was attributed in part to more 
perfect obedience and control of patients in the former. The 
influence of medicine in lowering mortality has just been es- 
tablished in Prussia, where it was ascertained by statistics 
that deaths are much more numerous in those districts where 
medical men are very few, than in the localities which have 
a proper number of medical practitioners. Life insurance 
companies will take no risks, unless the insured employ re- 
gular physicians. But why multiply facts on this point, 
when even quacks themselves are compelled to pay an un- 
willing tribute to medical science ; there is not one of them 
that does not employ, more or less of our means — the com- 
mittee in Congress proved their agents were only ours in 
disguise. And after all, with many people, it is not so much 
the science of medicine to which they object, but the charge 
for services rendered. For these and many other reasons 
which might be adduced, we must believe the community 
admit medicine to be a science ; the friends who have sent 
you here loudly proclaim it in your presence, and this audi- 
ence testifies to its interest among the people, 
18 



138 BIBLIOGRAPHICAL NOTICES. 

Physician and Patient, or a Practical view of the Mutual 
duties, relations and interests of the Medical Profession, 
and the community. By Worthington Hooker, M. D. 
New York. Baker fy Scribner, 1849. 

This is a work of 450 pages, and so far as we have read 
it, can testify to its value and interest. The work is di- 
vided into nineteen chapters, in which the uncertainty and 
the skill of medicine, popular errors, the different forms of 
quackery, and the means of removing them, the popular es- 
timates of physicians in community, views in regard to con- 
sultations, and interference with physicians, are severely 
treated of ; together with very wholesome remarks upon the 
influence of mind and body in disease — insanity — the influ- 
ence of hope in the treatment of disease — truth in our inter- 
course- with the sick — the moral influence of physicians — the 
trials and pleasures of a medical life, &c, all of which com- 
bine to make the work one of general interest with the pro- 
fession and others. The following paragraphs from the pre- 
face will give a fair expression of what the author has in- 
tended by publishing it. 

"But while I attempt to establish the claims of the medi- 
cal profession to the confidence of the people, and to defend 
it against the aspersions which are unjustly cast upon it, I 
endeavor to exhibit faithfully the abuses which exist in the 
profession itself. The quackery which is practised among 
medical men is a much greater evil than that which is 
abroad in the community. I attack it therefore with an un- 
sparing hand. In so- doing I expose many of the tricks and 
manoeuvres which are employed by those physicians, who, 
pursuing medicine as a trade instead of a profession, study 
the science of patient-getting to the neglect of the science of 
patient-curing. When the rules of an honorable professional 
intercourse shall come to be properly understood and appre- 
ciated by the public, one of the great sources of the success 
of quackery will be removed. 

« I write in part for the profession, and in part for the com- 
munity at large. I ask both to look candidly at the views 
which I present of their ( mutual duties, relations, and in- 
terests.'' A reform is needed in the opinions and practices 
both of physicians, and of the people, in regard to medical 



SANITARY CONDITION OF PHILADELPHIA. 139 

subjects. This reform is fairly begun in the profession, and 
there may be seen, even amid all the present diversified and 
flaunting displays of quackery, some indications of its com- 
mencement in the community. The volume which I now 
offer to the public is a humble effort to promote this reform." 
The typographical execution of the work is also good, 
and we hope it may be extensively circulated, both in the 
profession and out of it. 



The Sanitary Condition of Philadelphia : from the Re- 
port of the Committee on Public Hygiene of the Ameri- 
can Medical Association. Read at the Annual Meeting 
in Boston, 5th Mo. (May), 1849, and ordered to he 
published. By Isaac Parrish, M. D., Member of the 
Committee. Philadelphia : T. K. fy P> G. Collins, 1S4.9. 

The author of the pamphlet before us has exhibited a 
very commendable zeal in pursuing the subject proposed by 
the American Medical Association, and has elicited many 
important facts in regard to the causes of disease in Phila- 
delphia, which the authorities of that city would do well to 
consider. 

It is stated that the health of Philadelphia, is perhaps 
equal to that of any large city in the world, notwithstand- 
ing the great inroads that have been made from time to 
time upon the plans of its illustrious founder ; one of the 
most serious of which is the building up of the eastern part 
of the city; thus converting what was intended as a public 
promenade into a narrow, filthy avenue, filled with houses 
without yards, or other suitable means of ventilation, and 
constituting the chief source of pestilential and contagious 
disease ; the several yellow fever epidemics which have 
scourged the city of Penn, have commenced their origin in 
these compact and noisome squares. In the interior of the 
city, a great source of disease is found in the confined and 
narrow alleys and courts, where but little attention is be- 
stowed by the landlord to ventilation, or by the occupant 
to cleanliness. 



140 BIBLIOGRAPHICAL NOTICES. 

" In two blocks, not far distant from the centre of business, 
and selected without reference to any pre-eminence in this 
respect, it was found that, in one, six compactly built alleys, 
a.n&Jive closed courts existed, and in the other, four alleys 

and seven courts." 

****** 

" We hazard nothing in saying that the seeds of scrofula 
and consumption are sown here ; and that the more acute 
diseases, which are distinctly traceable to a deficiency in the 
supply of the natural elements for sustaining and developing 
the frame, must prevail in these confined situations. Hap- 
pily, the instincts of childhood lead the young being beyond 
the narrow confines of his cheerless home, and, when his 
strength will permit, he is prompted to active sports in the 
open air, which counteract, in part, the deleterious influ- 
ences by which he is surrounded in doors ; so that, in spite 
of these, his constitution, if naturally good, may become es- 
tablished on a firm basis; but still many perish before they 
are capable of seeking for themselves the air and light of 
heaven, and of establishing their claim to these natural 
rights. 

" The amount of infant mortality, in Philadelphia, believ- 
ed to be traceable to a combination of heat, moisture, and 
impure air, in confined situations, is sufficient to excite anx- 
ious inquiry. Cholera infantum, and other chronic bowel 
diseases, which annually carry off such a large number of 
children during the heat of summer, are known to be greatly 
influenced in their origin and progress by these causes. The 
cause of a large portion of these cases is as obvious as 
though it were tangible, and the cure often depends simply 
upon the removal of the patient from the crowded court or 
alley, to the pure air of the country. During a period of 
ten years, from 1838 to 1847 inclusive, 2,936 deaths are re- 
ported as having occurred from cholera infantum, and 119 
deaths from teething, in the districts reporting to the Board 
of Health. How many of these deaths came from the closed 
courts, crowded alleys, and illy ventilated abodes of the 
poor ? We imagine, without any means of accurate infor- 
mation, except a somewhat extended personal observation, 
that a large proportion could be traced to these situations ; 
and, hence, that they were, in a great measure, dependent 
upon removable causes. 

"During the same period, there were reported 2,450 
deaths from convulsions, in children under two years of age. 



BIBLIOGRAPHICAL NOTICES. 141 

May not many of these be fairly attributable to the same 
influences ? 

The facilities for drainage[appear to be sufficient to carry 
off offensive accumulations, were the municipal regulations 
to enforce cleanliness sufficiently adhered to. The sewerage 
under the city and surrounding districts, is ascertained to be 
about twenty seven and a half miles. 

The ventilation of public buildings is referred to as very 
deficient — there being no other means in the majority of in- 
stances, but by the opening of windows and doors. It is a 
matter of special surprise, that in the prisons of Philadelphia, 
so little attention is paid to this matter. The effect of long 
continued solitary confinement alone, is sufficient to break 
down the strongest intellect, and to impair the vigor of the 
most robust constitution. Add to this, a confined and vitiated 
atmosphere, and the cell of the prisoner, must of necessity 
be, the door of entrance to another world. The voice of 
reason, the claims of humanity, the dictates of wise legisla- 
tion, all demand a reformation in this system of penal disci- 
pline. How far the systems of what are known as separate 
and congregate imprisonment, contribute to the production 
of insanity — as well as a variety of physical disorders — is a 
question that is at this time exciting a deep interest in this 
country and in Europe, and is discussed in the pamphlet 
before us, particularly with reference to the comparitive in- 
fluence of the solitary system upon the constitutions of white 
and colored prisoners. The greater mortality of colored 
people is accounted for by the fact that the average length 
of their sentences for the same class of crimes is higher than 
that of white prisoners, and that they seldom partake of ex- 
ecutive clemency. 

We would be glad to notice other observations contained 
in the report before us, on the subject of prison discipline, 
but our limited space forbids any further remark. 



BIOGRAPHICAL NOTICES. 



BIOGRAPHICAL NOTICE OF THE LATE GEORGE Mc'CLELLAN, M. D. 
BY G. S. MORTON, M. B. 

It was remarked by a celebrated historian, that a man 
cannot speak long of himself without vanity; and the maxim 
may, perhaps, be extended to those who discourse of their 
friends. On the present oceasion, therefore, I shall study to 
be brief. 

George McClellan was born on the 22d of December, 
1796, at Woodstock, in Connecticut. His family, which 
was highly respectable, was in part of Scotch, in part of 
English lineage, and afforded several enthusiastic partisans 
of freedom in the war of Independence. 

The subject of these remarks, after receiving the usual 
academical instruction in his native town, and under the 
watchful eye of an affectionate father, entered the Sopho- 
more class of Yale College at the age of sixteen years, and 
in due time received the honors of that venerable Institution. 

His collegiate life was marked by singular quickness of 
perception, readiness in the acquisition of knowledge, and 
an enthusiastic, but immethodical devotion to his studies. 
His talent particularly displayed itself in mathematics and 
the languages : in the former, he showed proficiency; in the 
latter, his attainments were far above mediocrity. He also 
manifested a fondness for natural history ; and his zeal and 
success in its cultivation, are favourably recorded in the 
early numbers of the American Journal of Science, then, as 
now, edited by the distinguished Professor Silliman. 

His collegiate education completed, we next find this 
young man, in the year 1817, pursuing his medical studies 
in this city under the direction of the late Dr. Dorsey. Here, 
again, his restless activity and sleepless vigilance in the pur- 
suit of knowledge, were remarked and admired by all; ex- 
citing the surprise of his fellow students, and drawing from 
older heads, the presage of future distinction. He took his 
medical degree in 1819, and at once entered on the arduous 
duties of his adopted vocation. 

We do not propose to follow the phases of this gifted 
mind through its professional cycle of thirty years. To the 



GEORGE MC'CLELLAN, M. D. 143 

eye of the casual observer, the path of the physician pre- 
sents, from day to day and from month to month, the same 
unvaried uniformity, — a perpetual recurrence of similar 
scenes and circumstances, of which the busy world feels 
nothing and knows nothing. But how different is it with 
him, who, in the struggle of distinction, is alternately cheered 
by hope and dashed by disappointment — warring with ca- 
price, mingling with disease, and contending with death I 
These things however, are buried with the dead. They 
pass into oblivion ; or at most, nothing remains of them 
except a few scattered memorials, which rise like Wrecks 
upon the sea to attract the attention of the beholder. 

It is to some of these more prominent events in the life of 
Dr. McClellan, that I now propose to advert. In so doing, 
I feel conscious of acting in accordance with his views while 
living ; and " the wishes of the dead, when they can be dis- 
covered," observes the younger Pliny, "should be taw to- 
an honest mind." 

After having given a private course of anatomical lee- 5 
tures, Dr. McClellan conceived the bold idea of founding a 
new medical school. With him, thought and action were 
simultaneous ; a memorial was addressed by himself and 
others to the Legislature of Pennsylvania, and a charter was 
obtained in the winter of 1824, for the Jefferson Medical 
College. 

I venture to assert, from a personal knowledge of the 
time and circumstances, that no professional innovation was 
ever more unfavorably received by the physicians of Phila- 
delphia, than this. It had a direct tendency to isolate its 
author, and certainly influenced his destiny throughout life. 
It was assumed and asserted that there was not patronage 
for the support of two schools, and that the new one could 
only succeed at the expense of its elder rival. And inas- 
much as the whole scheme was regarded as a professional 
heresy, it need not be added that its partisans met with no 
favour. 

Dr. McClellan reasoned differently. He maintained that 
students would flock to this city in numbers proportioned 
to the increased facilities for education ; and that each insti- 
tution might be amply supported without any conflict of in- 
terest. What has been the result? In the place of five 
hundred students, which was the maximum number before 
this competition was organized, Philadelphia now annually 
enrols a thousand ; embracing a portion of the genius and 
talent of every state of the Union. 



144 BIOGRAPHICAL NOTICES. 

It is important, however, to observe, that owing to the 
general disapproval of the plan of a new College, Dr. Mc- 
Clellan met with great difficulty in organizing a medical fa- 
culty; and his colleagues were unavoidably chosen from 
among men greatly inferior in talent to himself. Incongru- 
ous elements were .thus associated together; dissensions 
arose, and disunion followed. Yet notwitstanding all these 
adverse circumstances, Dr. McClellan had the satisfaction, 
in the year 1836, to welcome no less than 360 pupils into 
the school he had founded. 

Dr„ McClellan's lectureship was Surgery : and he conti- 
nued his instructions in this branch until the year 1838, 
when for reasons unknown to the writer of these pages, the 
professorships of Jefferson College were all vacated by the 
decision of the Board of Trustees, and a new organization 
took place from which Dr. McClellan's name was excluded. 
This new faculty was composed of men of distinguished at- 
tainments. The medical public acquiesced in the change ; 
Jefferson College was received into favour, and collegiate 
competition was thereby legitimised. So true is the adage 
that times change, and we change with them : " Tempora 
mutantur et nos mutamur cum illis." 

Dr. McClellan thus lived to experience the proverbial 
misfortune of most pioneers and discoverers^ who sow the 
Seed of which others reap the harvest. 

Mortified but not discomfitted, by this adverse issue of 
his cherished plans, Dr. McClellan immediately conceived 
the project of a third medical school ; and with characteris- 
tic buoyancy of spirit and determination of purpose, he 
went in person, accompanied by a single professional friend, 
to solicit a charter from the State Legislature. Corporate 
privileges were in consequence, granted to an institution 
entitled, " The Medical Department of Pennsylvania Col- 
lege/' at Gettysburg, and McClellan, with five associates, 
of whom the writer was one, commenced the initiatory 
course of lectures in Philadelphia, in November, 1839. 

This institution had an auspicious beginning in a class of 
nearly one hundred pupils, between which number as a 
maximum, and eighty as a minimum, it continued under 
the direction of the same faculty for four consecutive years. 
Notwithstanding this seeming prosperity, it is due to Dr. 
McClellan's memory to state, that some injudicious pecuni- 
ary arrangements, entered into in the first instance, and in 
which he had no part, tended to embarrass the institution 
through the entire period to which we have alluded. 



GEORGE MC^CLELLAN, M. D. 545 

The sinister effect of these arrangements was soon felt by 
all concerned; and nothing but a mutual sense of honor 
sustained the faculty, in combined exertion, during four an- 
nual courses of lectures, the last of which terminated in the 
spring of 1843. 

Soon after this date, the entire faculty resigned their pro- 
fessorships into the hands of the Trustees. The motive that 
influenced a part of these gentlemen in taking this step, may 
be inferred from the preceding statement; other members 
were influenced, at least in degree, by other considerations 
to which it is here unnecessary to advert. It may, perhaps, 
be safely asserted, that Dr, McClellan was the only member 
of the faculty who abandoned this, his last and cherished 
enterprise. His zeal and enthusiasm could see nothing but 
success in the future ; and he never abandoned the convic- 
tion, that further perseverance would have crowned with 
commensurate reward. 

The remaining portion of Dr. McClelland life Was passed 
in the active duties of his profession. His final illness was 
severe, his death sudden. On the morning of the 8th of 
May, 1S47 ? he assisted in the performance of two surgical 
operations. He came home soon after noonday, complained 
of indigestion, which was quickly followed by symptoms 
analogous to those of bilious colic. These increased every 
moment in severity. Medicines at length afforded some 
mitigation of his suffering, and for a short time, gave pro- 
mise of relief; but it was presently observed, that as his 
pain abated, exhaustion and restlessness followed. These 
symptoms increased towards evening, and at eleven o'clock 
at night, to the surprise and dismay of his family and friends, 
the hand of death was evidently upon him. His mind con- 
tinued clear, but his articulation became hurried and indis- 
tinct. At midnight he was pulseless, and soon afterwards 
fell asleep ; and this state of unconscious tranquility he died 
at half past one o'clock the same night. 

As a surgeon, Dr. McClellan established for himself a re- 
putation that has become proverbial wherever the healing 
art is esteemed and fostered. Few men in private practice, 
in this country, have operated so frequently. His list in- 
cluded almost every capital operation known to surgeons, 
together with others that were original with himself; and 
these multiplied efforts of his genius were awarded with a 
full share of success. 

His almost intuitive perception of disease, led to a prompt- 



146 BIOGRAPHICAL NOTICES. 

ness of decision and a rapidity of operation that were some- 
times regarded as akin to rashness. The sight of blood, 
however profusely poured out, never dismayed him, because, 
as he remarked, he knew how to control the bleeding ves- 
sels. Every cut of the knife was made with the confidence 
that could result only from knowledge. In the midst of the 
severest operations, he continued his conversational remarks 
with the same coolness as if he had been a mere spectator ; 
whence it happened that differently constituted minds infer- 
red that he was unfeeling, and even cruel. 

I cannot, perhaps, offer a better commentary on these 
points than a memorandum of my own, bearing the date of 
March 8, 1845, which I transcribe verbatim: 

" The day before yesterday I was present at an operation 
performed by George McClellan, on a gentleman from Vir- 
ginia. It consisted in the removal of the whole of the pa- 
rotid gland in a schirrous and much enlarged state, from 
the left side of the face. Nothing could exceed the com- 
bined coolness and skill manifested by Dr. M. throughout 
this terrible operation, which he has now performed for the 
eleventh time, and hitherto with remarkable success. On 
this occasion, however, he was doomed to disappointment, 
for the patient died last night, about thirty-six hours after 
the operation. McClellan sent for me in the evening, to see 
the dying man with hkn, and we met in the chamber of 
death between ten and eleven o'clock, I had sometimes 
heard McClellan spoken of as a heartless surgeon, devoid of 
feeling or sympathy for those who came under his knife ; 
but I can solemnly aver that I have seldom witnessed more 
unaffected sorrow than he manifested on this occasion. He 
walked the room incessantly, and repeatedly clasped my 
hands in his, while he expressed, in emphatic language, the 
feelings that preyed upon his mind. He moreover assured 
me, that he seldom performed one of his severer operations 
without first asking the blessing of God on his undertaking ; 
and that days and nights of painful anxiety, often preceded 
those great professional efforts which have placed his name 
on the pinnacle of surgical fame. The gurgling respiration 
of the unfortunate patient announced the near approach of 
death, and I withdrew, full of sympathy for the agonized 
emotions of my friend." 

Dr. McClellan's excellent classical education was blended 
with a continued fondness for literary pursuits, and a lively 
interest in general science. He read much, but wrote little. 



GEORGE MC ? CLELLAN, M. D. 147 

He always took up his pen with reluctance : and it was only 
at the earnest and long continued promptings of his friends, 
that he at length commenced his " Principles of Surgery/' 
The first printed sheet was placed before him during his 
brief illness; but he was already too much exhausted to 
notice its contents. The work however, has been ably 
edited by his son, and it is now before the world an abiding 
memorial of the skill and genius of its author. 

Novelty in practice is not the test of excellence or supe- 
riority in either surgery or medicine. The annals of our 
profession are full of proofs of the truth of this axiom. Dr. 
McClellan has made no parade of originality ; but he has 
set forth, with the hand of a master, the multiplied experi- 
ence of more than a quarter of a century ; and this experi- 
ence was no doubt as extensive as that of any private prac- 
titioner among us, during that long period of professional 
£oiL Skill, decision and promptness were in him remarka- 
bly conspicuous, and they were combined with a judgment 
that had become matured in the school of observation and 
reflection. In the " Principles of Surgery," we find no 
temporizing treatment, no timid practice ; but. the positive 
knowledge of a mind that knew and relied upon its own re- 
sources. 

Dr. McClellan possessed a sensitive and generous spirit, 
blended with a confiding manner that strongly marked his 
intercourse with men. His feelings were quickly excited 
and warmly expressed at the sense of unkindness or injus- 
tice ; but there was a magnanimity in his nature that readi- 
ly forgave an injury. He often regretted the differences 
into which he was led by the impulsive indiscretion of 
youth ; and emphatically declared, that were it possible to 
live that part of his life over again, his course should be 
influenced by greater conciliation and forbearance. In con- 
nection with this subject, however, it must not be over- 
looked, that the period between the years 1820 and 1830 
was one of peculiar professional disunion ; and that Dr. 
McClellan, in common with many of his medical brethren, 
was hurried into controversies which, if they cannot be for- 
gotten, should at least be -remembered with charity. 

That Dr. McClellan possessed some of those traits called 
the "infirmities of genius," we are free to admit: but we 
may observe, in passing, that such infirmities are not, per- 
haps, more common to genius than to dullness itself. The 
difference is simply this — that they are conspicuous by con- 
trast in the one, while they are despised in the other. 



*4S BIOGRAPHICAL NOTICES. 

Dr. McClellan was remarkable for exuberance of thoughf ; 
and this attribute was responded to by corresponding volu- 
bility of speech. In lecturing or in conversation, he was 
never at a loss for words ; yet in spite of this amazing flu- 
ency, his ideas manifestly accumulated more rapidly than 
his tongue could give them utterance. He was communi- 
cative and confiding to the last degree, without seeming to 
be governed by those prudential considerations that habitu- 
ally influence mere cautious minds. 

He was married in the year 1820, to Elizabeth, daughter 
of the late John H. Brinton, Esq. and five children yet sur- 
vive him. The eldest, who is one of our colleagues, already 
holds an enviable position in our common profession. The 
second son, after graduating with great distinction at West 
Point, fought throughout the campaign in Mexico, from 
Vera Cruz to the capital, thus sharing the glory of the 
a - great Captain" who has won the laurels of Cortez unsul- 
lied by crime. — Transactions of the College of Physicians 
of Philadelphia, 



THE LATE PROFESSOR HARRISON, 

John Pollard Harrison was born in the city of Louisville, 
June 5th, 1796, and was therefore in the 54th year of his 
age. His medical studies commenced in the city of Louis- 
ville, but the principal part of his pupilage was spent in the 
office of Dr. Chapman, of Philadelphia. He graduated in 
the University of Pennsylvania, in the spring of 1819 ; and 
immediately on his return to Louisville commenced prac- 
tice. Dr. Harrison continued the practice of his profession, 
in the city of Louisville, in a successful and highly credita- 
ble manner, until 1835, a period of sixteen years, when he 
removed to Philadelphia. During his residence in Louisville, 
Dr. Harrison for several years held the office of physician to 
the Louisville Marine Hospital, in which he occasionally 
delivered clinical lectures. Shortly after his removal he ac- 
cepted the Professorship of Materia Medica in the Medical 
Department of Cincinnati College until its suspension, in 
1839, when he retired to the private duties of his profession. 
In 1841, he was elected to the chair of Materia Medica in 
the Medical College of Ohio; and in 1847 he was transfered 
to the chair of Theory and Practice in the same school. In 
1849, after having delivered two courses on Theory and 
Practice, he was restored, at his own suggestion, to the chair 



PROFESSOR HARRISON. 149 

of Materia Medica. It will thus be seen that he discharged 
the duties of a professor for a period of twelve years. 

The deceased held several important and honorable posi- 
tions in different medical associations ; he was elected pre- 
sident of the Medical Convention of Ohio, which met at 
Lancaster, in 1843; he was appointed by the American 
Medical Association, which assembled in Baltimore, May, 
1848, chairman of the committee on Medical Literature, and 
he was elected Vice President of that body, at its recent 
meeting in Boston. 

Professor Harrison was a ready and copious'writer, which 
is abundantly attested by his numerous contributions to me- 
dical journals. Daring his connection with the Cincinnati 
College, he was one of the editors of the Western Journal 
of Medicine ; and since that period he has contributed many 
articles to periodicals, chiefly, however, to the Western 
Lancet. The first original communication published in the 
Lancet was from his prolific pen, and his contributions occu- 
pied a conspicuous place in every volume of that periodical. 
In 1847, Professor Harrison became associated in the edito- 
rial management of the Lancet, which connection was con- 
tinued until the period of his decease. 

In addition to journal articles, Professor Harrison was the 
author of numerous public lectures, mostly introductories to 
his courses of medical instruction. His public lectures were 
always spirited and eloquent, his subjects well chosen and 
amply discussed — -qualities which seldom failed to please an 
audience, and which was evinced by the almost uniform 
publication of his discourses. We presume that his pub- 
lished lectures are more numerous than those of any other 
professor in the United States for an equal number of years. 

The more permanent works written by Professor Harri- 
son, consist of a small volume entitled, " Essays and Lec- 
tures on Medical Subjects," published in 1835; and his 
larger work on Materia Medica, consisting of two volumes, 
published in 1845. These works evince a profound ac- 
quaintance with the subjects upon which they treat, which 
would do honor to any author. One of the best articles, ac- 
cording to our judgment, ever written by Professor Harri- 
son, is an essay entitled, " Medical Experience," published 
in the volume of essays above alluded to. 

In all the positions in which Professor Harrison was 
placed, whether as a writer or lecturer, he manifested an 
enthusiasm, energy and capacity surpassed by few in our 



150 BIOGRAPHICAL NOTICES. 

profession. His mind was well stored with general inform 
mation ; and in the profession of medicine his reading was 
most extensive and profound. Endowed with quick percep- 
tive faculties, a strong memory and untiring industry, he 
could not fail to acquire a vast fund of knowledge. We 
have never met with a physician who retained a more vivid 
recollection of the sentiments and language of authors, and 
whose ability was greater to quote, at any moment, and to 
almost any extent, the views of nearly every prominent 
writer in our profession. 

Professor Harrison was, in every sense, a physician. He 
was not a mere trader in medicine ; but, imbued with a 
lofty and expanded view of the profession, he rose altoge- 
ther above every mercenary consideration, and was actuated 
alone by the purest motives and the most exalted sentiments. 
He never sacrificed principle to expediency, nor duty to 
interest ; but with an exalted purity and iron strength of 
purpose, his course was always guided by the dictates of 
truth, honor and justice. Dissimulation was to him un- 
known ; fraud and deception he knew not how to practice ; 
he never betrayed a friend, nor sought to injure a rival. In 
his immediate profession he was truthful to a most rigid and 
inflexible degree ; no love of gain or hope of applause could 
ever tempt him to violate those great laws of honor and 
fidelity which should ever pervade the conduct of the true 
and faithful physician. 

As a high toned and honorable gentleman, a consistent 
and exemplary Christian, Professor Harrison was equally 
distinguished. His sphere in social life, and in the Presby- 
terian church, of which he was an active member, was wide 
and influential. For thirty years he had been a professed 
Christian; and in his dying moments, when the dark sha- 
dows of eternal night were fast gathering around his pillow, 
his Christian hope shone brightly, and his aspiration ascend- 
ed to the skies. — Western Lancet. 



NEW JERSEY MEDICAL REPORTER. 

BURLINGTON, FIRST MONTH (JANUARY) 1850. 



EDITORIAL. 



NEW JERSEY PRISON REFORM ASSOCIATION, 

We had t J he pleasure, on the 16th Inst, of attending the 
first annual meeting of this association, at Trenton, and we 
are glad to have an opportunity of speaking a word to the 
medical profession of the state, upon the objects contem- 
plated by its organization; as they ought, in our opinion, to 
claim the attention, and command the interest of every en- 
lightened and philanthropic physician. The lamentable 
condition of the county jails, and of their unfortunate in- 
mates, was presented by the reporters from the several 
counties, all of whom united in the expression of the com- 
mon belief that the necessity for prompt reformation Was 
imperative. It needs but to be known that there is no regu- 
lar classification of the inmates, in a single county prison y 
that in all, the juvenile offender is allowed free and constant 
intercourse with the hardened criminal, — that the convicted 
and untried, occupy in common, a dismal apartment, — and 
that in some there is even no separation of the sexes, — in 
order to excite in every Jersey heart, the benevolent impulse 
which we trust may lead to the extension of every Jersey 
hand in behalf of this much needed reformation. And it is 
eminently appropriate for physicians to engage in the cause, 
as they, above all others, are qualified to suggest such sani- 
tory regulations as ought to be instituted, with other im- 
provements that may be contemplated by the association. 
As sound philosophy and true economy would dictate that 
no effort to reform the mind and morals can be successful, 
without an improvement of the physical condition of the 



152 EDITORIAL. 

prisoner, the first object would seem to be, to remove every 
cause, the tendency of which is to increase the degree of his 
degradation, and augment his inducements to commit crime. 
Hence old prisons should be so altered, and new . ones so 
constructed, as to promote the physical comfort and health 
of their inmates, and rules of order, cleanliness, and indus- 
try enforced, by which not only the criminal himself would 
be improved, but society relieved of a heavy tax for his sup- 
port. There is one subject to which we would solicit the 
particular attention of the medical profession — and that is the 
effect of the different modes of confinement upon the health 
of the prisoner. The public will look to physicians to en- 
lighten them upon this point ; and we hope that there does 
not exist a difference of opinion, in the profession, as to the 
fact that a rigid system of long continued solitary confine- 
ment must of necessity impair the vigor of the strong- 
est constitution ; because confinement to a single apartment, 
however well it may be lighted and ventilated, and how- 
ever much the person so secluded may be occupied with 
mechanical employment, is contrary to the physiological 
laws which govern the human constitution. We would 
therefore advocate the treatment of criminals as moral delin- 
quents, not merely as violators of law, subjected to the ven- 
geance of law, to make atonement for their disobedience ; but 
would surround them with influences the tendency of which 
is to improve their minds, by directing their thoughts to the 
contemplation of the pure and good. Insane persons, who 
are lodged in our asylum, are constantly attended by careful 
companions, in all their exercises, whether of labor, or mere 
enjoyment, because they are considered incompetent to take 
care of themselves, and if at liberty, would commit depreda- 
tions upon society. The criminal, too, while he should be 
punished for violation of law, and shut out from the sight 
and society of men, should be treated as a person morally 
diseased. He too, should be frequently attended by a careful 



EDITORIAL. 153 

guardian — taken out from his cell for a short time daily, 
and allowed to exercise his muscles, and breathe the clear, 
unpolluted air of heaven. During this exercise, and at 
other times he should be instructed in appropriate moral 
lessons ; and while in solitude, suitable books 'placed in 
his possession for self-improvement. Such a system, joined 
with physical labor in his cell, or an adjoining yard, 
(habits of neatness and order being cultivated the while,) 
would make our prisons, schools of moral reform, and 
the blessed means of restoration, to both the physical and 
spiritual man. We feel assured that the benevolent design 
of the association will be fully appreciated and sustained 
by the people of New Jersey; and that we may yet have a 
system of prison discipline which maybe effectual in elevating 
the degraded, aad reforming the vicious ; — while at the same 
time the physical constitution may be renovated by habits 
of industry and temperance. 



DR. S. WOOLSTON'S SPLINT. 

In the first number of our first volume we inserted a com- 
munication from Dr. Woolston, on the subject of his self- 
lengthening and adjusting splint, with a descriptive wood 
cut. We have never tested the value of the instrument by 
experience, and are hence unable to give any opinion upon 
its merits ; but we have before us a printed certificate, signed 
by a large number of physicians in this county, recommend- 
ing the splint to the favorable notice of the profession. Drs. 
Ridgway, Stratton, Read, Coleman, and Chapman have used 
it, and speak of it in terms of high commendation. It is 
simple, portable and cheap. Dr. Woolston is of cousre un- 
willing to procure a patent for the instrument, and has 
freely exposed it to the notice of his medical brethren. The 
Burlington County Medical Society, at its last meeting, ap- 
pointed a committee to examine it, and report to the next 

meeting upon its merits. We shall be happy ive publi- 
co 



154 ECLECTIC DEPARTMENT. 

city to the report when presented. Dr. Woolston is a gen- 
tleman much esteemed as a practitioner, and we hope that 
his laudable efforts to advance the science of Surgery may 
meet with the approbation which it may be found to de- 
serve. 



ECLECTIC DEPARTMENT. 

Remarks on Lead-Poisoning. By R. J. Kittredge, M.D* 

of Cincinnati. 

I am induced to offer the Lancet a communication on 
Lead-Poisoning arising from the drinking of cistern water, 
drawn through lead pipes, 

1st. — -Because it has never been a subject of any research 
in any part of the western country; and 

2d. — Because never having been much investigated, the 
medical public are too slow in recognising lead diseases. 

No physician who has thoroughly studied the subject, 
who has analyzed the water of many cisterns, containing 
water brought through lead pipes, can fail to come to the 
conclusion, that most waters will more or less corrode lead, 
and hold the salt in solution. 

Lead-poisoning exists in every degree, from the most se- 
vere case, to that which is so slight that its deleterious 
effects have not been experienced; yet at the same time 
there may be evident marks of the poison latent in the sys- 
tem, and if the patient be watched, time will develop a dis- 
ease, which these marks have indicated. 

Neither has any physician long investigated this subject, 
but what he has seen colic, paralysis, encephalopathy, and 
death result from the drinking of water drawn through lead 
pipes. Within a few days I received a letter from the dis- 
tinguished chemist, Samuel L. Dana, of Lowell, Massachu- 
setts: he says "I am now engaged in analyzing the organs 
of the late Dr. Pierce, of Tingsboro, who died of lead dis- 
ease, induced by drinking well water, drawn in lead pipe." 

It is hard to convince people that they are being gradu- 
ally poisoned, until they have felt the effects of the poison. 



KITTREDGE ON LEAD POISONING. 15£ 

But while we use lead as a conduit in this city, and when 
it requires no great chemical tact to detect quite a notable 
quantity of the metal dissolved in the waters of our cisterns, 
it would be unwise to say we are not continually using a 
slow poison. Many medical men tell me that they think 
the water here will not corrode lead, but I have found by 
experiment, the water used in this city, and the water of 
most of the country wells is eager to corrode this metal, and 
by the corrosion is formed an oxide or carbonate; then if 
lead pipe is corroded and worn out by having continually 
formed an oxide (PbO) or a carbonate (PbO.C 0), what be- 
comes of these salts of metal unless they are the whole time 
being washed into the cisterns; and it is by long continued 
and small doses that the system is sure to become poisoned. 

Having investigated this subject for three years, and hav- 
ing seen the most frightful effects of " lead pipe water " 
upon the system, I feared in this city to use our own, until 
the lead pipe, connected with the pump, was removed from 
the cistern and iron substituted, still leaving lead pipe con- 
ducting the water from the street to the top of the cistern. 
The cistern being empty I commenced rilling it, and of 
course threw away the first few pailsful that had been 
standing in and run through the pipe. At the same time 
I tested the first three pailsful for lead ; the quantity thrown 
down was enormous, certainly sufficient to taint the water 
of the cistern. Since that time, I have analyzed the water 
of some twenty cisterns ; in four I have found very alarm- 
ing quantities, and from two precipitates I have obtained 
metalic lead. 

If physicians in this city do not see many cases of lead 
poisoning, it is because, not suspecting lead, they too often 
confound the effect of this poison with other diseases. If 
lead colic exist, and we cannot trace immediate contact with 
some salt of lead, we suppose it to arise from some other 
source. If -a pain in the limbs, a weariness or weakness 
constituting lead arthralgy is experienced, it is called rheu- 
matism. And if we find a weakness of the fingers and hand, 
a' gloominess in mind, &c. unless there is decided colic or pa- 
ralysis, we are too apt to think that it is only a debilitated 
condition which the system happens, from some slight cause, 
to be laboring under. 

The constitutional effects of lead are indicated by a pur- 
ple or dark-red, perhaps a bluish line, from the twelfth to 
the twentieth part of an inch in width, on the edge of the 



156 RUPTURE OP THE SPLEEN, 

gums. It is almost an infallible sign that lead exists in the 
system, and yet too few medical men look carefully for this 
mark. 

" Being aware that " lead pipe water" endangers the sys- 
tem, are we in this city, and in other cities of the west, al- 
ways to use a slow poison in our houses, or will the medi- 
cal faculty be induced to fully investigate the subject, and 
take measures to remedy this evil ? Many, convinced of 
their danger, have already commenced taking the lead pipe 
from their cisterns, connected with the pump, and are put- 
ting in its place common two inch gas pipe (iron.) By so 
doing, and by catching and throwing away the first few 
pailsful that run through and have been standing in the lead 
pipe, bringing the water to the cistern, there is little danger 
that the whole water will become tainted. The cisterns of 
this city which have lead pipe connected with the pump are 
trebly liable to have their waters impregnated ; because, 
besides letting the water stand in the pipe coming from the 
street, and pouring it every five or six weeks, already im- 
pure, into the cistern, there is the pipe connected with f the 
pump, reaching to the bottom of the cistern, and presenting 
two surfaces to the continual action of air and water. — 
Western Lancet. 



Rupture of the Spleen. *ftutopsy. By M. G. Whitney, 
M. D., of Kingston, Pennsylvania. 

The patient was a man named Young, living in 

Wyoming Valley, aged about 40, a coal laborer, very large 
and muscular, subject to intermittent fever. On the night 
of the 24th of November, 1849, he was engaged with a 
party serenading a newly married couple, when, after 
drinking somewhat freely, and being partially intoxicated, 
a difficulty arose between him and one of his companions. 
In a struggle which ensued, Young being nearly down to 
the ground, was struck by his antagonist with the clenched 
fist, two or three blows on the left side, over the region of 
the stomach and spleen. Very soon it was observed that 
he was severely injured. He groaned, had difficulty of 
breathing ; his extremities became cold ; the pulse ceased at 
the wrists, and in about fifteen minutes from^the time of the 
scuffle he died. 

Inspectip Cadaveris. — About 38 hours after death, I 
made an examination. The body was altered very little by 



MUSCULAR CONTRACTIONS FROM CHOLERA. 157 

the process of decomposition. It was a little discolored on 
the back. The abdomen was much distended and tense ; 
on opening it, a large quantity of fluid and coagulated blood 
was found in the cavity. The viscera were carefully re- 
moved, and on inspection, the spleen was found about three 
times the normal size, of a dark greyish color, and having 
three rents or ruptures on the convex side, extending trans- 
versely across its body. There was a large quantity of co- 
agula around and under the stomach and spleen ; all the 
other abdominal viscera had a healthy appearance. I did 
not measure the spleen, but should think it was about ten 
inches long, four or five inches broad, and about four inches 
thick at the thickest part. The rents were about two inches 
apart, and extended into its substance about one inch. No 
further examination was made. — Med. Examiner. 



On the Muscular Contractions which occasionally hap- 
pen after Death from Cholera. 

Mr. Barlow has noticed two striking cases in which the 
movements occurred after dissolution, and lasted for a very 
considerable time. The muscles of the arms, chest, and legs, 
and, in one of these examples, those of the face, were ob- 
served to be affected, some muscles being much more in- 
fluenced than others. Some of the movements in respect of 
form were not unlike those of volition. In one of these cases 
the motions ensued two minutes after death ; in the other, a 
quarter of an hour. In both, the muscles of the lower ex- 
tremities were first affected, and the movements appeared 
successively in those of other parts. Two cases, very well 
marked, accurately observed, and presenting very similar 
features to the foregoing, and which had occurred long ago 
in India, were referred to. The author described those more 
local and transient forms of the affection which were more 
commonly observed ; the movements might be confined to 
the legs, the chest, the face, to a single muscle, or even to 
certain fibres of it. A case of cholera was on record in 
which paralytic muscles had been affected by spasms. These 
post-mortem contractions had been stated, by an observer, 
to admit of excitement and aggravation by " pricking." The 
writer had endeavoured, in one instance well-calculated for 
experiment, to repeat the observation, but had been unsuc- 
cessful. He had used, also, water of the heat of 150°, and 



158 MUSCULAR CONTRACTIONS FROM CHOLERA. 

of a yet higher temperature, in order to discover if the mo- 
tions could be either induced or affected by it ; no definite 
result could be obtained. Probably these motions, which 
had as remarkably narrow a sphere of action in some cases 
as they had a wide one in others, would have been much 
more frequently met with, had they been oftener sought for. 
Attention was directed to the terror which they had caused 
to ignorant persons and persons not ignorant ; they had given 
rise to unfounded notions of persons being buried whilst yet 
alive. They had been seen by friends, to their extreme 
amazement, as they were watching the bodies of the de- 
ceased relatives ; and it was necessary, with the view of pre- 
venting groundless alarm and false conclusions, that all 
persons who might come in contact with the corpse of those 
who had perished from cholera should be informed that it 
was by no means extraordinary for such actions to be wit- 
nessed after death in this disease. The author had no ex- 
planation to offer of the cause or causes of these curious 
phenomena. For the present, they must be viewed as facts. 
Groundless speculations would only surround them with un- 
necessary mystery. He concluded by proposing a careful 
inquiry into all the circumstances under which they occurred ; 
and some points were specified which it would be interest- 
ing to consider. Amongst other things, it was important to 
note their duration and the most protracted interval which 
might elapse between dissolution and their commencement. 
[This automatic movement of defunct cholera patients 
was one of the remarkable features of the disease, first 
noticed by us in 1832. The first instance which occurred 
in the wards of the Redcross Street Hospital, in the borough, 
excited no little commotion, the bed-clothes being com- 
pletely removed by the movement of one arm. The pheno- 
menon subsequently became so common, as to cease to ex- 
cite attention. We noticed at the same period the return of 
the natural temperature of the living body, as an universal 
fact, and in some few instances the cessation of life was so 
imperceptible, that we could only assure ourselves that the 
patient was dead by feeling the return of warmth to the 
previously ice-cold surface.] — Ed. Prov. Med. fy Sur. Jour. 



EARLY PREGNANCY: AND INFANTILE MENSTRUATION. 150 

Early Pregnancy : and Infantile Menstruation. 

In the London Medical Gazette, for 3d November, 1848, 
Mr. John Smith publishes a recent case of Early Pregnancy. 
It is interesting not only from the extreme youth of the mo- 
ther, but from the fact of her having borne a living and 
tolerably healthy infant. The following is Mr. Smith's nar- 
rative : — 

"At the Coventry Assizes, of August, 1848, Julia Amelia 
Sprayson preferred a charge of rape against her uncle, James 
Chattaway, who was convicted of the assault, and sentenced 
to two years' imprisonment and hard labor in the House of 
Correction. The girl was far advanced in a state of preg- 
nancy, and as it is of rare occurrence for conception to take 
place at so early an age as between eleven and twelve years, 
many, surmises were expressed by the gossips as to what 
would be the probable issue. She continued in good health 
up to the day of delivery, which took place on the 16th 
September, 1848. In the early part of the morning she be- 
came restless and uneasy ; and from the hour of 11, A. M., 
slight pains occurred at irregular intervals, until about 5, P. 
M., when it was evident that labor was rapidly advancing. 
On being sent for soon after, in consequence of the absence 
from town of Dr. Dewees, who had been engaged to attend 
her, I proceeded to make an examination, when I found the 
pelvis of average dimensions, and the os uteri about the size 
of a shilling piece $ but as the parturient throes were active, 
and returned every eight or ten minutes it appeared pru- 
dent to remain until the case had terminated. Nothing 
remarkable supervened during the progress of the labor, 
except that it was of unusually short duration. From first 
to last she was not "more than ten hours ailing, while 
the period of actual labor was not extended beyond four 
hours, and this would have been further shortened but 
for the smallness of the external outlet. The subsequent 
symptoms were just as favorable as the labor had been 
short. The lochia ceased after the lapse of a few days : 
the mammae became duly developed, and the secretion of 
milk was so copious as presently to suggest to her mother 
the idea of seeking for a situation as wet nurse. The infant 
at birth was long, slender, and emaciated, but rather below 
the average size, and in many respects may be said to have 
borne a striking resemblance to the offspring of mothers who 
had been imperfectly nourished during pregnancy. It did 
not occur to me at the time, either to place it in the scales, 
or to take its admeasurement, but at the time of writing this 



160 early pregnancy: And infantile menstruation. 

report (23d October, 1848,) it is 8i pounds in weight. The 
present weight of the mother is 104§ pounds. When she 
had so far recovered as to take a share in domestic avoca- 
tions, it seemed advisable to pay her an early visit, to elicit, 
if possible, some farther information than what had trans- 
pired in court, with a view of establishing some data as to 
the period of uterogestation ; and although foiled and disap- 
pointed with the result of this part of the investigation, some 
particulars of interest were readily obtained. She was ra- 
ther of prepossessing appearance, of fair complexion, with 
brown hair and dark grey eyes ; more womanly by far than 
is usually witnessed at her age, her figure being tolerably 
plump, well set and proportioned, and her height being ra- 
ther more than five feet ; and notwithstanding her casually 
childish manner, there was that forwardness of expression 
which betokened a more than ordinary developement of 
character. On inquiry her mother assured me that she began 
to menstruate when ten years and six weeks old; and it 
was distinctly ascertained that there had been a regular 
return of the catamenial discharge, in somewhat profuse 
quantity, up to the period at which conception took place. 
The girl had lost her father about two years ago, and that 
she might not be a burden to her widowed mother, had been 
in residence with her uncle, who was a weaver at Foleshill. 
This unhappy man, who proved her seducer, was aged forty- 
seven, living with his wife, to whom he had been married 
twenty-five years, and by whom he had had a family of two 
or three children. The neice was taught to weave at a 
handloom, which stood in the same apartment in which her 
uncle pursued his daily employment ; and here it would 
seem that familiarities arose which issued at length in crimi- 
nal intercourse. This latter took place for the first time 
about the middle of November, 1847, and was allowed to be 
repeated on four occasions at weekly intervals ; but as the 
catamenia had appeared during the last week of that month, 
and did not recur in the Christmas week, she dated concep- 
tion from the latter period. No communication was made 
to her relations of what had transpired until six months had 
elapsed, when her situation became too prominent to elude 
further observation, and then it was that arrangements 
were made for bringing her under the maternal roof; and 
means were taken for delivering her seducer into the hands 
of justice. The most rigid inquiry failed in deducing any 
farther particulars that could be at all relied on as authentic 
information. "—British American Journal 



THE 

NEW JERSEY MEDICAL REPORTER, 

VOL. III. FOURTH MONTH, (APRIL,) 1850. No. 3. 

BIOGRAPHICAL NOTICE. 



BIOGRAPHICAL MEMOIR OF DR. MOSES BLOOMFIELD, 
By Elias J. Marsh, M. D. 

The desire to prolong the names and memories of those, who 
in their day, were examples of usefulness and virtue, is an 
instinct of natural piety. So strong is this feeling, and so 
grateful its exhibition, that we more readily pardon an over- 
fondness for the relics and memorials of departed worthies, 
than the neglect of them. These memories bind the present 
to the past, and the hope of perpetuating them connects us 
with the future, and makes successive generations a living 
and enduring whole. Every community and profession, 
which would have other than an ephemeral existence, and 
produce other than triflers, and deeds worthy of such, will 
have a history, and cherish the names worthily recorded 
there. Even domestic and humble narratives of professional 
or civic worth, and unostentatious benevolence, are not with- 
out their use. The esteem and reverence paid to such names, 
teach the young that there are rewards more worthy of toil 
and effort, than gold and sensual gratification ; that at death, 
all of the good do not die, they continue to excite our admi- 
ration, to claim our homage, and their example is still a liv- 
ing influence around, and in us. 

Moses Bloomfield is one of those names which the medi- 
cal profession in New Jersey ought not willingly to let die ; 

his services to his profession, to his country, and to humani* 
21 



162 BIOGRAPHICAL MEMOIR OF 

iy in general, are deserving of a record. This respectable 
physician was born Dec. 4, 1729, and lived in the township 
of Woodbridge, Middlesex county, a place of more note in 
the early annals of the state than now ; here he practised 
physic and surgery for forty years ; fulfilled the duties of ma- 
gistrate and representative of the Provincial Congress and 
General Assembly, and was at the time of his death, as re- 
corded on his tomb-stone, senior physician and surgeon in 
the hospitals of the U. States. 

Dr. Bloomfield was associated with other physicians of 
East Jersey, in organizing the State Medical Society, and 
was chosen first Secretary in 1766, and afterwards Presi- 
dent in 1785. The society soon after its formation, witness- 
ing the deplorable evils brought on the community, and the 
debasement of a necessary and honorable calling, hy travel- 
ling mountebanks, and uneducated and unprincipled persons, 
assuming the name and office of doctor, and pretending to 
practice the healing art, appointed Doctors Cochran and 
Bloomfieid a committee to introduce the subject to the legis- 
lature, and procure the passage of a law, prohibiting under 
suitable penalties, any person from practising physic or sur- 
gery in the state, without having previously passed an ex- 
amination before a board appointed for that purpose, and re- 
ceived a certificate of being duly qualified. The committee 
succeeded in their application, and a law was passed in 1771, 
which, with proper modifications from time to time, has con- 
tinued in existence to the present, and without doubt has 
contributed to maintain the character and dignity of the 
medical profession, and the esteem and confidence of the 
public in it. Efforts have been made at various times by 
charlatans and interested parties in other states, to procure 
the repeal of the law, and allow all persons bearing diplo- 
mas from other states, to practice in this, without further 
inquiry or examination : but hitherto these attempts have 
failed. The gross abuses which have arisen from the union 
of the teaching and licensing powers in other states, the 



DR. BLOOMFIELD. 163 

great number of medical schools which are springing up 
over the country, and not called for by the legitimate wants 
of the profession, but are mere creatures of private specula- 
tion, and the manner in which diplomas have been sold, 
may, it is to be hoped, lead the legislature to pause, and con- 
sider well before they break down the barriers which now 
keep out, in a degree, incompetent and immoral persons 
from a profession, whose members from the very necessities 
of society, are brought into the closest and most confiden- 
tial relations with families. The profession can take care 
of its own interests and dignity ; and when we ask for a 
continuance of these safeguards, it is not for our own pecu- 
niary interests or selfish ends, but for the welfare of hu- 
manity. 

In the colonial differences, Dr. Bloomfield was a whig, 
and when the struggle came on, he not only took a decided 
part himself, but furnished a son, then a student at law, and 
afterwards governor of the state, to the army. While his 
principles were thoroughly whig and American, his sympa- 
thies and charities were wide enough to hold in their em- 
brace persons of the most dissimilar political sentiments. 
Many of his warmest personal friends belonged to the oppo- 
site party. On one occasion he was captured and taken 
within the British lines, where one of his tory friends to 
whose family he had shown many kindnesses during this 
civil strife, speedily procured his release and sent him home. 
Difference of political principles, and even civil war, with 
such men did not suspend the charities of life, nor prevent 
the interchange of good offices. 

But the crowning act of Dr. Bloomfield's life, one in strict 
accordance with his principles and character, and for which 
his memory should be held in perpetual remembrance by 
the people of this state, was the part he took, by precept and 
example for the abolition of slavery. Warm from the revo- 
lutionary struggle, and grateful for the civil freedom he had 
gained, he would have the greater boon of personal liberty 



164 BIOGRAPHICAL MEMOIR. 

extended to the weaker and more unhappy African race* 
Unlearned in the logic of that school, (indeed that school had 
not yet come into existence,) which teaches that slavery is 
the firmest and truest support of liberty, the mother of high 
civilization, and the nurse of all generous arts and heroic 
deeds, he would have all men free. Forever foreign to his 
mind and heart would have been the cold reasonings of a 
political philosophy, and the cravings of a sordid interest 
which doom to hopeless and perpetual bondage, any of God's 
rational creatures. Not so, did he read the Declaration of 
Independence, and that much greater work, the book of Life. 
Accordingly, after the termination of the war, he made all 
haste to emancipate his slaves. It took place on the 4th of 
July, 1783, the first anniversary of the signing of the Decla- 
ration ot Independence after the war, at a public meeting 
which has been called the first anti-slavery meeting ever 
held in the United States. We give an account of the trans- 
action in the words of the poet Whittier. 

" The public meeting took place in the township of Wood- 
bridge. Great preparations had been made ; an ox was 
roasted, and large numbers assembled to partake of it, and 
to listen to the orator of the day, Dr. Bloomfield, father of 
the late governor Bloomfield g of New Jersey. At the ap- 
pointed time the orator mounted the platform, followed by 
all his slaves, fourteen in number, seven of whom took 
places on his left and seven on his right, while he addressed 
the multitude on the evils of slavery. At the close of his 
speech, he turned to his slaves, stating, that inasmuch as 
we, as a nation, had declared all men equal, he could not, 
consistently hold slaves. Why, asked he, should these my 
fellow citizens be held in bondage ? From this day they are 
free. 

In the midst of the applause which followed, the Doctor 
called up to him one somewhat in advanced in years. "Hec- 
tor," said he, " when you cannot support yourself, you are 



BIOGRAPHICAL MEMOIR. 105 

entitled to a maintenance from. my property. When do you 
suppose you will need that maintenance." 

The delighted negro held up his left hand, and with his 
right drew a line across the middle joint of his fingers ; 
" Neber, massa, neber, so long as any of dese fingers are left 
above dese joints." 

" There fellow citizens," said the Doctor, " you see that 
liberty is as dear to the man of color as to you or me." 

The sentiments and example of the father were not with- 
out their influence on his son ; he was a strenuous advocate 
for the abolition of slavery, and the first act for its gradual 
abolition was passed in 1804, while he was governor of the 
state. 

In the narrow circle of village life and practice, " his vir- 
tues walked their daily round," for eight years longer, when 
he departed this life in the 63d year of his age, leaving a 
son and two daughters, one of whom, the widow of a phy- 
sician, still survives, and her condition strongly illustrates 
the need of a provision for the widows and children of me- 
dical men. 

Paterson, March, 1850. ' 



ORIGINAL COMMUNICATIONS. 



BURLINGTON, FOURTH MONTH. (APRIL,) 1850. 



NOTES ON THE CHOLERA IN PATERSON IN 1849. 

BY E. J. MARSH, M. D. 

Paterson, in common with the other large towns of the 
country, suffered much from the late epidemic cholera. I 
had many opportunities of seeing various forms of the dis- 
ease, and the results of different modes of treatment, and 
thinking that some notice of it may not be uninteresting to 
the readers of the Reporter, I will briefly and informally note 
down some facts and observations relating to it. I do this, 
however, not in the hope of eradicating in the least, the 
cloud of darkness which envelopes the cause, nature, and 
proper treatment of this much dreaded disease, but to add 
somewhat to the mass of facts which are accumulating, and 
from which, perhaps some future happy genius may draw 
useful generalizations. We may reasonably hope that at 
some future period organic chemistry or microscopic obser- 
vation may detect the specific poison which causes it, and 
happy accident or improved therapeutical science, lead to an 
antidote. 

With the revival of the humoral pathology, and the belief 
that it is fast gaining ground, that not only our epidemical 
diseases, but many of the most formidable disorders of the 
animal economy, such as epilepsy, tetanus, hydrophobia, 
&c., which hitherto have been least amenable to medicines, 
arise from specific poisons circulating in the blood, the search 
for specific remedies, is coming into fashion. Nearly three 
centuries ago, Lord Bacon, in his essay on the advancement 
of learning, spoke of medicine as appearing to him to move 
in a circle, and that the attention of the profession ought to 



MARSH ON THE CHOLERA. 167 

be more given to the searching out for specifics. Most of 
the great achievements of practical medicine have been 
made in this direction. Witness the discovery of mercury, 
peruvian bark and vaccination, as specinces for three of the 
greatest scourges of the human race. But this is a digression. 
Paterson is situated on the Passaic river, just below the 
Great Falls. An elevated range of trap rock, overlaying 
sand stone, extending in a semi-circular form, encloses it on 
the west and north. A portion of the town is on high, 
sandy soil, and well drained by natural position ; another, 
and the more compactly built portion, and where the mill 
operatives and laboring part of the population chiefly reside, 
is low and wet; the ground having been originally a bog 
meadow, which has from time to time been filled up with 
sand. This ground is capable of being drained, but for the 
want of proper municipal government, no means have been 
adopted for its drainage. In rainy weather the water often 
overflows into the basements and cellars of the dwellings, 
where it remains for days and even weeks. In this part of 
the town, the disease was most severe. 

Paterson, with the adjacent village of Manchester, is esti- 
mated to contain from fourteen to sixteen thousand inha- 
bitants, engaged chiefly in cotton and iron manufactures, 
and their auxiliary trades and occupations. Intemperance 
prevails to a great extent, and many of the operatives, 
although not actually sick, are laboring under a condition 
of chronic ill health. 

Cholera made its first appearance on the 30th of May, 
1849, in the district known by the name of Dobbin. This 
part of the town is elevated and drained, but the streets and 
yards of the houses were in a very filthy and offensive state. 
The disease lingered for some days in this spot, occasionally 
taking off a victim, when it gradually extended itself over 
the town 5 — its greatest severity was felt in the low part of 
the town already spoken of, and known as the meadow. I 
have seen persons, living in the damp and ill-ventilated cel- 
lars of this district, seized without any premonitory symp- 



168 MARSH ON THE CHOLERA, 

toms, with the cramp and rice-water evacuations of cholera, 
and die within a very short time. Medicines, although ad- 
ministered immediately and faithfully, had no influence on 
the progress of the disease in most of such cases. Removal 
to more favorable localities was in some instances followed 
by recovery. The poison seemed to adhere to these damp 
and filthy abodes of wretchedness and poverty, and after 
the death of one of a family, in such cellars, unless the re- 
mainder was removed, others soon were seized. In this way 
I witnessed whole families cut off. 

Different modes of treatment were pursued by "different 
physicians. I give my own experience. I found the mo- 
derate use of ripe garden fruits and well-cooked vegetables, 
beneficial rather than otherwise. A strict meat and farina- 
ceous diet deranged the digestive and nervous system, and 
the disease, when it seized such persons, was more than or- 
dinarily severe. At the first appearance of the diarrhoea I 
made use of the following : 

R. Acetate of Morphine, gr. i. 

Powdered wood charcoal, 3 i. 
Divide into powders, x ij. 

One or two of these powders, with quietude in the horizon- 
tal position, in the vast majority of cases, checked the dis- 
ease in its earliest stage. The vomiting was best checked 
by small doses of kreasote. In cases of collapse the tinc- 
ture or etherial solution of camphor was administered as a 
stimulant, while calomel, in half grain or grain doses, was 
administered every fifteen or twenty minutes, as an alterative. 
Constant dry friction with the bare hand was in many cases 
continued for hours. Under this treatment I have seen pa- 
tients come out of the cold, blue and pulseless state of cho- 
lera-collapse, and recover rapidly without any succeeding 
fever. Care was taken not to allow such patients, for seve- 
ral days, any solid food, but to confine them to beef tea, or 
other similar animal broths. More cases of recovery from 
collapse occurred in my own practice, and in that also of 
Dr. Rogers, in females. The cases of children were gene- 



MARSH ON THE CHOLERA. 169 

rally of a mild type ; the evacuations were less, less ten- 
dency to collapse, but congestive fever was more apt to fol- 
low. Drink was freely given ; ice administered according 
to the desires of the patient. Effervescing draughts were 
very grateful to the patient, and allowed him at pleasure. 

Of the saline treatment recommended by Dr. Edward 
Stevens, I can say but little. On this mode of treatment the 
evacuations are not early checked, but rather encouraged, 
as elimanating the morbid poison from the system. An un- 
fortunate and fatal case occurred after the taking of a dose 
of epsom salts. I heard of no cases of the use of the wet 
sheets. I was taught by one case that the patient is not al- 
ways safe even after bilious evacuations have been procured 
with secretion of urine and quiet sleep. In this case the 
patient was considered out of danger, when from no known 
cause, vomiting came on, accompanied with severe spasms, 
and the patient rapidly sunk. Any exertion on the part of 
the sufferer, even an attempt to drink, brought on the vo- 
miting and spasms. The alterative action of the calomel 
was perceptible in the swelling of the gums and the breath 
of this patient. The poison seemed to have an affinity to 
certain organizations or blood. Members of the same fami- 
ly, living miles apart, and having little or no personal inter- 
course, suffered from the disease. Some families suffered 
very severely, losing several members. 

Few diseases, if any, are more affected by depressing or 
exhilerating emotions of the mind than cholera. While fear 
disposes the system to an attack, and by prostrating the en- 
ergies, prevents recovery, the physician finds in the confi- 
dence and hope of his patient his most powerful helps. I 
know of no physician or nurse who took the disease while 
attending on the sick. 

While the cholera was prevailing in Paterson, one Joseph 

Schloster, a charcoal burner, living 15 or 16 miles from the 

town, in the mountainous part of the county, came to the 

town to sell a load of coal ; while here he is said to have 
22 



270 HAINES ON THE USE OF JARVIS* ADJUSTER.' 

indulged too freely in eating and drinking. He returned 
home the same day, Tuesday — he complained of being un- 
well on Wednesday — he was taken down next day with the 
cholera, and died on Friday. His body was kept unburied 
until Sunday, when it had become very offensive. His 
friends and relatives were invited to attend his funeral from 
the house, and after the burial, returned to the house and 
took dinner. On the next day, Monday, a brother-in-law, 

Shippers, who had been at the funeral, took ill and died; 

on Tuesday another brother-in-law and son, who had also 
been present, died; and during the week the wife of Schlos- 
ter and two of his sons died, and also a laboring man in the 
family. All these were cases of cholera. No cholera or 
similar disease had been in the neighborhood before this, 
and no other person had an attack subsequently. The dis- 
ease was confined to this single family, and to the persons 
present at the funeral in the house. 

The disease disappeared gradually from the town, or 
seemed rather to be merged into the bilious diarrhoeas and 
dysenteries which prevailed during the fall months, and was 
followed by the small pox, which is now prevailing in mild 
and modified forms in Paterson. 



REMARKS ON THE USE OF JARVIS* ADJUSTER IN FRACTURE 

OF THE OS-FEMORIS, WITH CASES. 

By Job Haines, M. D. 

Abner R., aged fourteen years, was run over by a two 
horse wagon, loaded with marl ; I was sent for to see him, 
and found him in a house near where the accident happen- 
ed, lying on a bed, with a cold and shrunken skin, and al- 
most pulseless. On examination, a simple fracture of the 
os-femoris of the left side, and a compound fracture of the 
same bone, of the right side were discovered. On the latter, 
existed a transverse wound two inches long, at about the 



HAINES ON THE USE OF JARVIS* ADJUSTER. 271 

point of junction between the middle and upper thirds of 
the bone, from which a considerable quantity of blood had 
escaped : the lower end of the upper fragment was distinct- 
ly felt at the bottom of the wound. Brandy and water were 
administered, and he was conveyed to his home. A few 
hours afterwards the necessary apparatns was applied with 
the assistance of my friends, Doctors Spencer and Stokes of 
Mooresto wn. The simple fracture of the left side was read- 
ily adjusted, by the application of the bandage of Scultitis, 
Dessault's splint, &c. &c. The other, on account of the ex- 
treme tumefaction, was placed for the present on a double 
inclined plane, with the addition of a little extra extending 
force. The wound was cleansed, and a poultice applied: in 
this condition he was left for the night, with directions to 
take laudanum if he should be restless. The next day I 
found him suffering from retention of urine, for the relief of 
which, fomentations were applied above the pubis, and spts: 
ether, nitrici, administered. 

It is worthy of remark here, that in addition to the above 
remedies, the boy desired the application of the poles of a 
galvanic battery, to the use of which he had become some- 
what accustomed, as one was in possession of the family ; 
the retention was relieved under its use ; though whether 
the relief is to be attributed to its action upon the muscular 
coat of the bladder, or to the other remedies named, is un- 
certain. On my next visit, the swelling of the right limb 
was found to be much reduced ; some clots, and a little 
healthy pus, had been discharged from the wound, and 
crepitation was very distinct. Upon a more critical exami- 
nation after the subsidence of the swelling, a second frac- 
ture of the bone was discovered, the upper one oblique, with 
considerable displacement, the lower transverse, with but 
little change from its normal direction ; [the middle frag- 
ment was about two and a half or three inches long : it was 
very difficult to retain the upper third in situ. The patient 
seemed now tolerably comfortable, though the pulse ■ was 



272 HAINES ON THE USE OP JARVIS* ADJUSTED 

rather feeble, and the bowels costive : to relieve the consti- 
pation he took three of the pil: cathat: comp:, the next day 
the bowels were relieved. A straight splint was now ap- 
plied to the right limb, which was made to correspond very 
nearly in length with the left. There was a good deal of 
difficulty in retaining the bone of the right side in its pro- 
per position, owing to the shortness of the upper fragment, 
the oblique direction of the fracture, and the extent of the 
wound, but little room being left to apply the upper roller. 
At the end of two weeks there did not appear to be any 
evidence of re-union of the fracture near the wound, while 
the other was doing well ; the left one was also re-uniting 
finely, and the limbs were about the same length. The 
eighth week arrived, no bony union had taken place at the 
oblique fracture, and fears were entertained of a false joint. 
The other fractures were by this time soundly united. Just 
at this period an agent for the sale of Jarvis' Adjuster came 
along, and placed in my hands the patent instrument ; I ap- 
plied it as directed, and was enabled readily to maintain the 
length of the limb ; the bones were brought into appropri- 
ate contact, and osseous union not long after commenced. 
After a tedious convalescence the patient recovered, though 
with an unnatural turning of the foot outwards : the peculi- 
arity in his gait would not however, be noticed by a pass- 
ing stranger. 

Remarks. — In this case, the supportthat is often obtain- 
ed from a sound limb, could not be had ; the proper length 
could not be as decidedly ascertained, as both limbs were 
the seat of fracture, hence they were both extended as near- 
ly alike as possible : the length of time that necessarily 
elapsed between the occurrence of the accident, and the ap- 
plication of the dressings, and the necessary removal from 
the place where the injuries were received, to his home, all 
contributed to complicate the case, and render the reduction 
of the bones, and subsequent treatment, more difficult. The 
adjuster invented and patented by Dr. Jarvis, was applied 



HAINES ON THE USE OP JARVIs' ADJUSTER. 273 

with satisfactory results in this case, and it is but justice to 
admit the fact, in remarking upon the claims of the instru- 
ment, to professional favor ; it is a complete instrument for 
cases which exactly suit it, but its general applicability to 
fractures of the femur is, we think justly questioned. A 
case recently occurred to me of a child two and a half years 
old, who fell and broke the os-femoris of the right side ; the 
apparatus could not be applied to employ the extending 
force that was necessary in the case : a smaller one could 
not be made on account of infringing upon the patent right. 
The instrument fails in its applicability to all cases, because 
it does not admit of modifications which different cases seem 
to call for. It is put up in a handsome mahogany box, with 
a multiplicity of bands, tapes, strings, &c. &c, and a red mo- 
rocco slipper tacked on to the foot-board, which will not 
probably, fit the foot of a single patient. 

The ratchet, we consider the only really useful part of the 
whole apparatus ; the rest you may as well throw away as 
to pretend to make them practical and general in their ap- 
plication to fractures of the thigh. The perinoeal band, for 
example, will become so soiled by using in a single case, 
that you are compelled to procure a new one for the next, 
and the same may be said of the remainder of the straps 
and bandages. We do not pretend to deny that it may be 
a sightly addition to the stock of surgical apparatus about a 
hospital, or may answer to illustrate the views of its invent- 
or before a class of students, but we are not prepared to 
award to it the merit which is claimed for it by Dr. Jarvis, or 
his agents. It looks well while the plausible and stereo- 
typed description of its value is being brilliantly portrayed 
by the interested agent, and he is very willing to pocket a 
fifty dollar note as the fee for his gratuitous advice ; but 
when you come to use it in practice, it is a very different 
thing. You cannot always have your patients of the proper 
size and age, and fractures do not always occur exactly to 
suit the instrument. What we want is a splint to fit the 



174 VENOUS EXTRAVASATION INTO THE LABIA. 

fractured limb, and not a fractured limb to fit our apparatus. 
This we consider to be a real point of difference between 
Dr. Jarvis' instrument and that justly celebrated modifica- 
tion of Dessault's splint, by the late Dr. Physick. 
Mount Laurel, March, 1850. 



CASE OF VENOUS EXTRAVASATION INTO TEE LABIA 
BEFORE PURTURITION. 

BY ALEXANDER W. ROGERS, M.D. 

In December, 1848, 1 was sent for to assist a colored wo- 
man in labor. On the way I learned from her husband that 
she was the mother of seven children, and before this had 
always been delivered easily without medical aid. When I 
arrived at the house, 1 found the woman rolling on the bed, 
suffering what appeared to be violent throes of labour. 
Upon enquiry I found that she had been in labour some 
twelve hours ; and that she had felt as if she would get 
through at every pain for some time past — that she was now 
getting tired out, and was afraid that something was wrong. 
Upon applying my hand to the perineum, I found one side 
of it enormously distended with what felt considerably like 
the head of a child. But I could not find the usual cleft be- 
tween the labise, and was puzzled as to the nature of this 
unusual presentation. I now made an occular inspection, 
and found that the left labia was distended larger than the 
size of a child's head, and the right drawn entirely out of its 
usual site — the nymphae entirely obliterated; and the left 
wall of the vagina drawn a third of its usual length to form 
a part of the covering of this globular swelling. The peri- 
neal surface of the swelling was very tense and shining, and 
the vaginal surface of a dark livid color, and covered par- 
tially with a bloody fluid oozing from it. Upon applying 
my hand to the abdomen a child could be easily felt ; but 
upon passing the finger from the swelling along the vaginal 



VENOUS EXTRAVASATION INTO THE LABIA. 175 

wall to the uterus the head of the child could not be dis- 
tinctly felt, nor the os uteri discerned. 

Enquiry being made whether there was any swelling of 
the labia before the pains came, the woman said that she 
had noted a small swelling there some months before, but 
that it gave her no pain, and did not trouble her. She 
knew nothing of the present enormous distension of the part 
till her pains came on, and evidently thought that it was 
the head of the child pressing down. Upon holding the 
hand for some time on the part, no pulsation could be felt in 
it. It therefore appeared pretty clear that the case was one 
of excessive extraversation of venous blood into the cellular 
tissue of the labia and contiguous parts. 

The question now presented, How is this difficulty to be 
removed ? for certainly it must be before parturition can be 
completed. I sent a request to Dr. Wm. Magee, to see the 
case with me; and upon consultation we concluded to 
puncture the swelling with a lancet, and see how far it 
might be diminished. A stream of dark venous blood fol- 
lowed the puncture, and the excessive tension of the'part 
was considerably lessened. After waiting some time I found 
that the pains, though severe, were not effective, and as the 
woman was tired and impatient, I gave her a full anodyne, 
and left her. During the course of a week after this, pains 
came on several times and ceased again, without parturi- 
tion becoming fairly established. In the mean time the 
labial surface of the swelling sloughed to some extent, and 
the coagulated contents, by degrees, separated. The wo- 
man became considerably exhausted, and her strength was 
sustained by gentle stimulants and wine. The surface of 
the swelling was kept moist by diluted tincture of iodine. 
The swelling was now all gone, and an ulcer the size of a 
dollar, on the inner surface of the labia was all that was 
left. This was beginning to show healthy granulation, 
Labour'now came on, and she was delivered without diffi- 
culty. A day or two after parturition puerperal mania ap- 



276 PARRISH ON DYSPEPSIA. 

peared and continued in a violent raving form for a fort- 
night. Her strength was supported by wine and ammonia, 
beef tea, &c. An occasional full dose of sulphate of mor- 
phine procured rest, and she gradually recovered. It is not 
uncommon to meet with cases of extravasation into the la- 
bise after parturition, the result of difficult labour ; but ex- 
travasation before parturition, especially to like degree with 
the above case, I believe is seldom met. with, and therefore 
think it may be interesting to my medical brethren. 
Paterson, March, 1850. 



REMARKS ON THE PATHOLOGY AND TREATMENT OF 
DYSPEPSIA, AS IT EXISTS AMONG SHOEMAKERS. 

By the Editor. 

Having had an opportunity for several years past, of ob- 
serving the character and course of dyspepsia, as it occurs 
among a large proportion of the population of this city, I 
have thought it might be interesting to the profession, and 
perhaps not without profit , to communicate the results of 
these observations. The city of Burlington, being located 
on the shore of the Delaware river, and of convenient access 
to the two great cities of the Union, as well as to the sur- 
rounding country, by steamboat and railroad travel, offers 
many advantages as ^a place of business for the manufac- 
facturer, and as a healthy location for residence. It is built 
upon a plain of rich loamy soil, remarkable for its produc- 
tive yield of the finest garden fruits and vegetables ; the 
river skirts the northern and western sides of the town, and 
in the rear, a little distance from the city, is an elevated 
ridge of land, not surpassed by any section of the state for its 
salubrity, and the general health of its inhabitants. The As- 
siskunk creek forms the eastern boundary, and though 
skirted along its banks with meadows, which extend across 
to the river on the west, is quite healthy for a low situation. 



PARRISH ON DYSPEPSIA. 177 

The general health of the city is good, and I know of 
nothing in its topography that is calculated to engender gas- 
tric disease , while this class of disorders would probably 
form the maximum if arranged in statistical order. Its 
prevalence is, I have no doubt, partly attributable to 
the habits and pursuits of the people among whom it 
is mostly to be found, just as scurvy is almost peculiar 
to seafaring people. Hundreds of young men and ap- 
prentices may be found, particularly in the winter sea- 
son, from six o'clock in the morning till ten at night, upon 
the bench, taking only a few minutes at a time for their 
meals. Out of the twenty -four hours, not more than one is 
usually devoted to meals, and about seven for rest; so that 
nearly two-thirds of their entire time, during the six work- 
ing days of the week, is spent in the stooping posture, in 
small and hot apartments, plentifully fumigated with tobacco 
smoke, or the vapor arising from burning quids upon a red 
hot stove. A few are in the habit of using intoxicating li- 
quors to excess, though I am free to testify that very many, 
on the other hand, are our most consistent advocates, by 
word and deed, of temperance principles. From the brief 
outline thus drawn of the habits of life of shoemakers in 
Burlington, it is very easily seen that they invite the 
enemy to human health to dwell in their midst. The 
stooping posture, the want of exercise, the hurried eating, 
the confined atmosphere of their apartments, the smoking 
or chewing of tobacco ; — all contribute to lessen the vital 
energies, and to engender disease. That the stomach 
should be the first organ to suffer, is easily accounted for ; 
not only is the food taken in haste, without sufficient masti- 
cation, and thus an unnatural demand made upon its pow- 
ers, but it is often unsuited in quality to the wants of the sys- 
tem ; the constantly stooping position compresses the organ, 
interferes with its normal action, interrupts the gastric circu- 
lation, and impedes somewhat the salutary movements of 

the lungs ; the want of exercise, and of fresh air, produces a 
23 



178 PARRISH ON DYSPEPSIA. 

languid circulation, tends to local congestion, gives rise to a 
sense of fulness, and produces constipation of the bowels, 
while the use of tobacco is in every way injurious. 

The free use of tea and coffee, may also be mentioned as 
a cause which contributes to disorder the digestive appara- 
tus. It is a well known physiological fact that these arti- 
cles of diet do not supply in any appreciable quantity, the 
organizable material, which is necessary to the formation 
of healthy blood; hence the proper degree of animal heat 
cannot be maintained, and the vital forces must sink below 
par. CofFee is mostly taken for breakfast, and tea for din- 
ner and the evening meal; and though they may have a 
tendency to exhilerate the nervous system, and to enliven 
the spirits, their real value will not admit of even a mode- 
rate estimate. It becomes us then, first to enquire, what 
are the pathological changes which take place under such a 
mode of life ; and secondly, how can they be remedied. A 
patient who has pursued such a course of living presents 
himself for treatment. He is not sick enough to stop his 
work, and yet is not well. He rises in the morning feeling 
dull and inactive. After breakfast he complains of pain in 
the stomach, sometimes in the side, it may be the right or 
left ; his skin is dry, often cool, and pulse generally feeble ; 
his tongue is slightly coated at its base, with an unhealthy 
odor of the breath ; not unfrequently the appetite is unsually 
good, oftener however, it is quite moderate, and but seldom 
is the food rejected. The stomach seems to demand the sti- 
mulus of food, although the natural taste and appetite for it 
may be impaired. Constipation and flatulency are general- 
ly attendant symptoms also — palpitation of the heart, head- 
ache, a slight cough and sore throat are also sometimes com- 
plained of. The stomach being oppressed by excess of in- 
digestible or innutritious food, the circulation being languid 
in consequence of position, and want of exercise, the patho- 
logical condition would seem to be, that of congestion of the 
gastric vessels, and loss of nervous power in the organ. 



PARRISH ON DYSPEPSIA. 179 

The first object to be gained, is to cleanse the stomach 
and bowels ; for this purpose I have generally employed a 
full dose of magnesia and rhubarb, preceded by a blue pill, 
if it should be indicated ; the former neutralizing the acid 
secretions which generally exist in the alimentary canal, 
and the rhubarb acting upon the muscular fibres so as to 
produce copious feculent dejections. Abstinence from tea 
and coffee, and from all fried food, whether animal or vege- 
table, with boiled or roasted meat for dinner, and bran 
bread, with milk, or milk and water for breakfast and sup- 
per. This system of diet, with daily exercise in the open 
air, as walking two or three miles daily, will generally so 
modify the action of the vital forces, as to bring about a 
condition in which the system will more readily respond to 
the subsequent treatment. In the majority of cases, the 
constipation of the bowels is the most obstinate symptom to 
overcome, as the occupation of the patient is so habitually 
sedentary —but I have found as a gentle daily evacuant, 
pills made according to the following prescription to act 
kindly upon the bowels : 

R. Ext: Colocynth: Comp: grs. xxiv. 

01: Tiglii. gtt. iii. 

ft. pilul: duodecem. 
Signa. Take two every every morning. 

After a while the pills may be discontinued, leaving the 
bowels so accustomed to a regular daily movement, that the 
necessity for cathartic medicine is removed, provided the 
patient is careful to put himself in the position and place for an 
evacuation, at stated intervals. The use of nervous stimu- 
lants and tonics, where there is considerable debility of the 
digestive organs, is very important to facilitate recovery. I 
have never found anything so effectual as quinine, assafoe- 
tida, and capsicum, combined or separately, as may be in- 
dicated in particular cases. A common and favorite pre- 
scription is as follows : 

R. Quin: Sulph: — G. Assafoetida, 

Capsicum, aa gr. xij., ft. pil. No. xij. 
Signa. One or two after each meal. 



180 



PARRISH ON DYSPEPSIA, 



Piperine maybe substituted for capsicum if preferred. The 
flatulency is generally relieved by the assafetida and capsi- 
cum, a gentle stimulant impression being at the same time 
made, while the tonic effect of the quinine upon the languid 
vessels, serves to keep up their action. The condition of 
the skin is such in most cases, as to require attention. It is 
alternately dry, and moist — dry during the day perhaps, 
and covered with acid perspiration at night. Daily ablu- 
tions are therefore enjoined, and frictions with a salted 
towel. The addition of an alkaline salt, as common wash- 
ing soda, to the water, has a delightful effect upon the skin; 
it renders it soft and pliable, and frees it from the peculiar 
acid secretion. I have frequently had patients to recover 
entirely after a fair trial of this mode of treatment, who have 
supposed themselves wasting with consumption. Indeed 
the symptoms of phthisis are often very closely imitated — 
the pale and shrunken visage, the attenuated frame, ha- 
rassing cough, and fugitive pains about the chest, resem- 
ble the common signs of pulmonary disease. A gentle- 
man, who has been a shoemaker from early life, called on 
me a few years since, and told me that he was suffering 
from a disease of the throat, which had been pronounced 
bronchitis by several skillful physicians, and though he had 
tried almost every known remedy for the disease, he was 
still left with a distressing cough, and offensive expectora- 
tion, with a sense of soreness in the throat, which indicated 
to his mind that he had not long to live. One physician of 
Philadelphia had told him, that to be cured, he must confine 
himself to a room of equal temperature, and not speak for 
several weeks, during which time he would make such appli- 
cations, and administer such medicines as in his judgment 
would be useful. The patient could not leave his business 
to comply with these regulations, and for awhile abandoned 
all treatment. In his capacity as a local preacher and class 
leader, of a numerous religious denomination among us, the 
muscles of his throat had been overstrained by extra use; 



PARRISH ON RHEUMATISM. 181 

he worked at his trade during the day, and several even- 
ings in the week was engaged in public religious exercises, 
He was advised to abandon these for a season, and give up 
the use of tea, coffee, and tobacco. Slight counter irritation 
was applied to the epigastrium, and under the use of the 
following prescription, with bathing, and exercise, recovered 
completely in less than two months : 

R. G. Assafoetida, grs. xxiv. 
Pulv: Capsicum, grs. xii. 
ft. pil. No. xii. 
Sig. Take two after each meal. 

Years of his life, and considerable money, had been spent 
in fruitless efforts, with active medication, advised by phy- 
sicians and quacks, to overcome a malady, the cure of which 
was within his own control, under a few simple instruc- 
tions. He now attends to his business with industry, labors 
in the pulpit and class room as zealously as ever, and withal 
enjoys good health. 

I have thus attempted to describe the" symptoms of dys- 
pepsia, as they have been observed by myself, among the 
shoemakers of Burlington ; and though I have not kept re- 
gular notes of many cases, I am quite certain that the treat- 
ment pursued, has resulted in the improvement and recovery 
of a large number of persons. 



Observations on the use of quinine and opium, 
in acute rheumatism. 
By the Editor. 
Being some miles from home, waiting the movements of 
an obstetric patient, I conclude to fill some of the blank 
sheets of my memorandum book, for the printer, with ob- 
servations on the use of quinine and opium, in acute rheu- 
matism. Almost every physician with ample opportunities 
for experience, after a few years practice, selects from the 
materia medica his favorite remedies tor the treatment of 



182 PARRISH ON RHEUMATISM. 

certain diseases ; for though we cannot always trace in the 
mind, a clear adaptation of the known properties of a medi- 
cine, to the morbid condition of the system for which we 
may be called upon to prescribe, we are sometimes tempted 
to depart from the beaten track, and enter the field of hy- 
pothesis, when we feel assured by past experience, that 
there is room for improvement. Acute rheumatism is a very 
common disease, for which a common mode of treatment 
has long been acknowledged. The presence of severe pain, 
active external inflammation, and a pulse above the normal 
standard, would seem to indicate the propriety of blood-let- 
ting as the primary remedy; such is the received opinion of 
the profession, and it is believed the majority of practition- 
ers act in accordance with it. My own experience has not 
warranted the adoption of this opinion. The symptoms of 
the disease under consideration need not be recapitulated 
here, they are familiar to the whole profession ; but there is 
one peculiarity in rheumatic inflammation which deserves 
special notice as having an important bearing upon the treat- 
ment ; it is its fugitive character, its tendency to remove sud- 
denly from place to place, and scarely ever to terminate in 
suppuration. At any rate it may be called a peculiar in- 
flammation. 

If a patient complains of acute throbbing pain in any part 
of the body, and the skin becomes inflamed and hot, press- 
ure intolerable, or even the slightest touch, and we witness 
the progress of this action from day to day, till suppuration 
is established and an abscess forms, we see a very different 
state of things from what happens in rheumatic pain and 
fever. In the latter the suffering may be as acute, the local 
inflammation as decided, and yet it will suddenly leave that 
part, and as suddenly fix itself upon a distant region of the 
body, or perhaps, if there exists any irritation or functional 
derangement of any of the internal viscera, it may be loca- 
ted there, as in the heart, stomach, or other organ. We have 
considered this to be a distinctive peculiarity of rheumatic 



PARRISH ON RHEUMATISM. 183 

inflammation, which demands of the practitioner a mode of 
treatment different from what is applicable to common in- 
flammation. Acting upon this view of the subject, the dis- 
ease has recently been treated as follows, with the happiest 
results : To evacuate the alimentary canal as a preliminary 
step, is obviously important ; for this purpose I generally 
prescribe a combination of ten grains each, of blue mass and 
prepared chalk, to be followed in a few hours with a full 
dose of magnesia and wine of colchicum; the bowels being 
freely moved, from five to ten grains of quinine, with from 
one to two grains of opium, according to the age and con- 
stitution of the patient, and the severity of the pain, are given 
at night : this will generally procure sleep and freedom from 
suffering during the following day ; the erTervessing mixture 
or small doses of Dover's powder are continued, at intervals 
of two or three hours, and bland mucilaginous drinks allow- 
ed, which serve to nourish the patient, and keep the bowels 
soluble. I have not unfrequently known the combination of 
quinine and opium to operate as a laxative, and thus remove 
the necessity of any other cathartic. Some twenty cases of 
the disease I have treated on this plan; not one of them lost 
a drop of blood, arid they all recovered speedily ; most of 
them were females. 

The applicability of quinine in scrofulous inflammation is 
generally admitted ; in rheumatic opthalmia it is often em- 
ployed, and in erysipelas its efficiency is not questioned. 
As a journalist and a practitioner of medicine, we are not at 
liberty to withhold from the common stock, any thing that 
promises advantage to the sick, or to the profession ; hence, 
these views are submitted with due deference to the opin- 
ions of those of more advanced age and experience, and who 
have enjoyed greater opportunities of treating the disease ; 
but they are the result of careful observation, within the 
limited sphere of my professional labors, and as such are 
submitted to the medical public. 



184 HEINTZLEMAN ON CONJUNCTIVITIS. 

COD LIVER OIL IN STRUMOUS CONJUNCTIVITIS. 

BY E. A. HEINTZLEMAN, M. D. 

On the first of December I was called to see J. P., a child 
seven years of age, labouring under disease of the eye, 
which upon examination I found to be a most inveterate 
case of strumous conjunctivitis, of nine months standing ; 
during which time various remedies had been tried, but with 
no other effect than aggravating the disease — found the 
child in a dark room with both eyes covered by a green 
shade ; the sensibility to light was so intolerable, that not- 
withstanding the precaution to exclude it, he would often 
bury his face in the bedclothes, to avoid its disagreeable 
impression. Any attempt to examine the eyes was attended 
with spasm of the orbicularis, the pain being so great that I 
was forced to desist from any further examination of the 
more deeply seated tissues. There were also offensive dis- 
charges from the nasal and auditory passages ; eruptions 
upon the face, and behind the ears ; bowels costive, tongue 
coated white, with anorexia. Judging from the symptoms 
that the exciting cause was a deranged condition of the 
chylopoetic viscera ; ordered powders [composed of hyd: 
cum creta, pulv: rhei: and magnes: to be repeated every four 
hours, with cups to the nape of the neck, and a light nutri- 
tious diet; which improved the general health, but exerted 
no influence on the diseased organ. I then commenced the 
use of quinine, ferri sulphas, and syrup: auranti, a favorite 
prescription of Dr. LittelPs, but with no better success — in 
fact it resisted all the ordinary modes of treatment. Having 
occasion to visit my friend, Dr. Joseph Parrish, of Burling- 
ton, I stated the case to him ; he suggested the use of cod 
liver oil, and a cold salt bath daily, with the occasional ap- 
plication of a smooth crystal of sulphate of copper to the in- 
flamed surface. On my next visit I ordered these remedies; 
and at the time I am now writing, which is just four weeks 
from the commencement of this course of treatment, there is 



N. J. LUNATIC ASYLUM. 185 

a most decided improvement ; the secretions are natural, the 
appetite good, the intolerance of light, and eruptions on the 
face having completely subsided ; and the patient is able to 
leave his place of confinement, and join his comrades in the 
open air, which no doubt will add greatly to a speedy cure. 
Columbus, April, 1850. 



BIBLIOGRAPHIC! NOTICES. 



Annual Report of the Officers of the New Jersey State 
Lunatic Asylum, at Trenton, for the year 1849. 

We always think we are doing the insane good service, 
when we call to the remembrance of our readers, the New 
Jersey Lunatic Asylum, and ask them to consider its claims 
for professional favor. All public institutions that have been 
established for a benevolent purpose, deriving their support 
in part, or altogether from the state, will be exposed to the 
opposition of interested partizans, and among the sovereign 
people, there will always be a few who think that their 
pockets ought not to be taxed to support crazy people in 
what is ignorantly considered an expensive style ; and we 
think it the duty of physicians, to the extent of their ability 
and influence, to counteract the false notion that the present 
system of treating insanity is an expensive system; never 
was there any policy more contracted than that of low prices 
in the board, and management of the insane. All experi- 
ence has proved that a liberal policy is the cheapest, or in 
other words, that the cheapest is the most expensive. When 
the asylum in New Jersey was first instituted, we believe 
that the act of incorporation provided for the payment of 
three dollars per week for pauper patients, by the counties : 
this regulation being complained of, the legislature of last 

year passed an act reducing the price to two dollars weekly, 

24 



186 N. J. LUNATIC ASYLUM 

for those patients who are indigent, or have become a pufc± 
lie charge 

In 1849 a deficiency was found to exist on account of 
this reduction, and the last legislature, in order to meet it, 
and complete some arrangements about the building, 
grounds, &c, appropriated more than six thousand seven 
hundred dollars. We make the following extract from the 
Managers Report bearing upon this matter, and commend it 
to the careful consideration of the reader. 

" The patients maintained in the asylum at the expense of 
their friends, have paid various prices, ranging as high as 
eight dollars per week. But it has not been deemed in ac- 
cordance with the humane principle upon which the institu- 
tion is founded, to look to this as a source of profit — it would 
be levying a tax upon the unfortunate which ought to be 
borne equally by all — and therefore the price to private pa- 
tients is always graduated so as merely to defray the ordina- 
ry and extraordinary expenses their friends are willing to 
incur in the accommodations provided for them. 

Before passing from this subject, it may be proper to say 
that at the first meeting of the board of managers, held after 
the passage of the act reducing the charge for pauper and 
indigent patients to two dollars per week, they appointed a 
committee of their number to confer with the superintend- 
ent, and in conjunction with him to adopt the most stringent 
system of economy in the administration of the domestic af- 
fairs of the institution which could possibly be devised, with- 
out abandoning the curative principle which was the great 
idea of the act which created the institution. To put the 
lunatic in chains — to secure him within the limits of four 
stone walls, and feed him till he dies — is one idea; and it 
disposes of him effectually, so far as the safety and security 
of society is concerned. But to look away from ourselves 
to him. — regard him as a case of misfortune without crime — 
a wandering star in the world of intellect to be won back to 
its proper orbit — a fellow citizen to be reclaimed by the body 
politic from the grasp of a terrible disease, is the idea which, 
alone, is worthy of a civilized state and a christian people ; 
and the committee have graduated the expenses with a 
pruning hand which has left nothing that can possibly be re- 
duced without abandoning this last idea, and throwing the 
institution back upon the first." 



REPORT FOR 1849. I 8 " 

We are aware that in the ranks of the medical profession 
there are those who have not very friendly feelings towards 
this institution ; and we are willing to admit that there has 
been a cause for it. We know that the New Jersey Medi- 
cal Society was the proud pioneer in the work of reclaim- 
ing the insane of New Jersey ; that a 'committee from this 
body first brought the subject before the legislature of the 
state, and that a medical commission was appointed to the 
work for which others have since obtained renown ; but the 
truthfulness of the statistical table which this commission 
produced after arduous labor, was the means of enlighten- 
ing public sentiment, and awaking public sympathy, so that 
at last, the great end of the society's efforts has been ac- 
complished. In its accomplishment, 'tis true, we have not 
received much courtesy; but three out of eleven managers of 
an institution organized for the treatment and cure of dis- 
ease, are physicians, while the medical heads of the Asylum 
have not complied with the rules which regulate the prac- 
tice of " physic and surgery" in all parts of the state. We 
do not mean to speak disrespectfully of these gentlemen: we 
entertain a high personal regard for both of them. We have 
received kindness and attention at their hands, which we 
shall be glad at any time to reciprocate, but we mention the 
fact as a cause for dissatisfaction with some valuable mem- 
bers of the medical profession in New Jersey. We wish the 
fact did not exist ; we hope it may not be long before the re- 
quisitions of the law may be complied with. Dr. Buttolph's 
report is the medium of statistical information as to the state 
of health of the household, and under the head of " general 
results and observations," the following paragraphs demand 
notice here. 

" The past has been a highly prosperous year to the in- 
stitution. One hundred and seventy-nine persons have en- 
joyed the benefits of its care, of which number forty-four 
have been restored to reason and their friends ; fourteen 
have been discharged as improved, two unimproved, and 



188 N. J. LUNATIC ASYLUM 

nine died ; leaving one hundred and ten under treatment at 
the date of this report. 

" No fatal epidemic disease or untoward accident has oc- 
curred during the year, to mark or mar its passage, and the 
number of recoveries have been so large as to encourage us 
to make increased efforts in behalf of the afflicted. 

" During the prevalence of cholera in neighboring places, 
a marked epidemic tendency to affections of the digestive 
organs prevailed in the institution, but no death or very 
alarming sickness of that character occurred. From the uni- 
form healthfulness of the members of our household, it is 
believed that no local causes of disease exist in the neigh- 
borhood, and that persons here residing enjoy as favorable 
circumstances for health, as in any other situation. 

" The institution in its arrangements and fixtures, has 
proved to be admirably adapted for the convenience, classi- 
fication and comfort of its inmates ; and in these respects, is 
justly entitled to rank among the best of modern construc- 
tion. For it, the friends of the insane and the citizens of the 
state generally, should entertain the highest regard, and 
yield to it their confidence and warmest support ; it being 
alike creditable to the intelligence and philanthropy of the 
age and state that gave it being." 

The success which has so far attended the government of 
this institution, is sufficient evidence of its usefulness to soci- 
ety. We have visited it several times, and have always 
felt proud of the state whose philanthropy has made such 
noble provision for its unfortunate citizens; and still more 
so of the profession, under the auspices of which, the treat- 
ment of insanity has been so wonderfully improved. We 
would heartily wish that every citizen of New Jersey could 
feel that the " State Lunatic Asylum" is the noblest monu- 
ment of benevolence which ever had a foundation in our 
soil ; and that all party bickerings, [and sectional jealousies, 
might vanish in view of the important truth, that it offers 
for each of us a home, where we may meet with kindly care 
from sympathizing friends, should we be overtaken with the 
direst calamity that can befal human nature. 



TRANS. AMERICAN MED. ASSOCIATION. 189 

The Transactions of the American Medical Association, 
instituted 1847, vol.2. Philadelphia — Printed for the 
Association, by T. K. and P. G. Collins, 1849. 

The great size of the volume before us, will prevent any 
thing like a fair notice of its contents. It occupies, with in- 
dex, list of members, &c.,956 pages, and we shall only refer 
to portions of the reports, which in our judgment will prove 
most interesting to our readers. The report on Medical 
Sciences, by Dr. Yandell of Louisville, Ky., is the first of the 
series, and embraces an interesting account of the progress 
of the medical sciences at home and abroad, with notices of 
important ^improvements and discoveries in the different 
branches of our profession, and the collateral sciences, which 
have a direct bearing on medical knowledge and progress. 
The subject of etherization is treated more in detail than 
most others embraced in the report, on account of its novelty 
and general interest, as well as from the fact that a wide dif- 
ference of opinion exists in the profession, as to the propriety 
of its employment. We give an abstract of the views of 
the committee. A number of cases of etherization in tetanus, 
which resulted favorably, are reported, not only in the form 
of the disease which occurs after injuries, but in the idio- 
pathic variety of the disorder. 

Chloroform and ether in the convulsions of children, are 
highly spoken of, as important remedial agents : one case is 
mentioned of a child only five months old, where it was 
used with success. We may here state that we have recent- 
ly employed it in an infant not five weeks old, with the ef- 
fect of relieving violent convulsions ; the inhalation always 
cut short the spasm. 

Its use is also mentioned in chorea, mania, hysteria, puer« 
peral convulsions, and delirium tremens ; several cases are 
mentioned, in which the spasms of cholera were mitigated 
under its use. In cholic, nephritis, and dysmemorrhea, 
this agent is said to have been highly useful where 
other remedies have failed to afford relief. In neuralgia, 



190 TRANS. AMERICAN MED. ASSOCIATION. 

the local application of the chloroform has proved highly 
beneficial, and in deep seated pains of the eye, even where 
large doses of opium were of little avail. Three cases of 
lumbago are reported, in which its application to the loins 
was followed by speedy reliet — its internal use is also favor- 
ably alluded to. The committee have also very properly por- 
trayed the dangers of these remedies. Some twelve cases of 
death, which are distinctly attributable to chloroform or 
ether, and a number of others more doubtful in their charac- 
ter, are reported by the committee. The Report concludes 
as follows : 

"When the practice had been pursued less than a year, 
Mr. Lawrence stated that the trials with ether in a single 
London Hospital had extended to between two and three 
thousand cases. One dentist in that city, up to the middle 
of July last, had administered anaesthetics more than three 
thousand times. In a London lying-in hospital, chloroform 
has been resorted to in every case of labour since it was dis- 
covered. At Paris, Velpeau says no operation is performed 
in the hospitals without it ; that ' the patients insist upon its 
use/ and the surgeons could not reject it if they would. 
Assuming, as there are good grounds to believe, that the 
operations performed in that metropolis amount to more 
than a hundred a month, there have been, in that city alone, 
up to this time, three thousand persons subjected by the sur- 
geon to the influence of anaesthetics. It can hardly be 
doubted that the number far exceeds this, when it is remem- 
bered that, within this period, Paris has been twice the the- 
atre of bloody conflicts which have filled her hospitals with 
wounded soldiers and citizens. In all the provinces of 
France, moreover, these agents are in common use with the 
profession, and as the reports of success and failures for the 
most part find their way into the journals of the capital, it 
may be presumed that the casualties attending the practice 
have generally transpired. And the result is, that, of num- 
bers almost numberless, who have been its subjects, ten, per- 
haps fourteen, have died. So many have fallen victims to 
anaesthesia in all Europe. 

The accidents from anaesthesia in the United States have 
all resulted from the inhalation of chloroform. In Europe 
thirteen deaths have been attributed to that agent, and three 



fRANS. AMERICAN MED. ASSOCIATION. 191 

to the use of ether. Of the deaths from ansesthetics, in all 
countries, thirteen have occurred in the hands of surgeons ; 
three have happened with dentists ; and two have followed 
the breathing of chloroform for its pleasurable impressions. 
Not one has been reported in the hands of the physician or 
accoucher. 

From all the facts before us, it appears that these agents 
are capable of destroying life, though, in a vast majority of 
instances, they may be used with perfect safety ; that chlo- 
roform, especially, is, to some constitutions, a prompt and 
certain poison, the more to be dreaded because, in the pre- 
sent state of our knowledge, we possess no antidote to its 
fatal powers. That they are by far our most potent and re- 
liable antispasmodics, and capable of varied and important 
therapeutical applications. That, in some cases, advantage 
is derived from a combination of chloroform and ether; and 
that, in some, where one has failed to secure anaesthesia, the 
other will accomplish the end desired. That they act with 
most energy when taken through the lungs, in the shape of 
vapours ; but that they may be administered with good ef- 
fect by the stomach, or applied locally for the relief of pain. 
That chloroform should be used with great caution, and 
only by professional men ; that care, during its inhalation, 
should be taken to secure a due admixture of atmospherical 
air with its vapour ; and that its inhalation ought to be sus- 
pended as soon as insensibility is obtained. That, finally, 
with all the drawbacks upon them, ansesthetics form a most 
precious contribution to the resources of our art." 

The report on Practical Medicine, by Dr. Condie, of Phi- 
ladelphia, is confined "to a notice of the epidemic diseases 
which have occurred during the past year." Typhus or 
ship fever has prevailed to a greater extent than usual in 
most of our large seaport towns. Erysipelas has been quite 
prevalent ; in some localities it has assumed an epidemic 
form, the most extensive of which were in portions of 
the eastern and western states; and the febrile exanthe- 
mata prevailed very extensively in many sections of jthe 
country. The report states, however, that the most "widely 
extended epidemic of the past year was unquestionably that 
of dysentery." " In one or more sections of the U. States, 
cerebro-spinal meningitis made its appearance as an epide- 



1.92 TRANS. AMERICAN MED. ASSOCIATION. 

mic." The details of this epidemic in Alabama, though 
very interesting, are too lengthy to admit of any extended 
notice. It also occurred in the towns of Millbury and Sutton, 
Massachusetts. Dr. Stone, of Auburn, who writes upon'the 
subject, states that every case, amounting in all to nineteen 
or twenty, proved fatal. " No plan of treatment has as yet 
been attended with any success, either in arresting its pro- 
gress, or modifying its character." The yellow fever visit- 
ed New Orleans again last year, though it was declared by 
the Board of Health, "that it had not assumed an epidemic 
character." It appeared also at the Quarantine station, 
New York. In Natchez, Mississippi, it also existed in a 
mild form. The latter part of the report is occupied with a 
narration of the history of the cholera epidemic — the chief 
incidents of which are already before the public. With the 
report are presented three communications from New Jer- 
sey, which are printed in full — the first from Dr. Garrison, 
of Swedesborough, on the prevalent diseases of that neigh- 
borhood during the past year ; the second and third from 
Dr. J. Fithian, of Woodbury, on the bilious fever, and ery- 
sipelas of the respiratory mucus membrane. 

In the report on Surgery, by Dr. Smith, of Baltimore, the 
subject of etherization is ably discussed as to its applicability 
in surgical cases. The merits of sulphhuric ether, and chlo- 
roform appear to be fairly compared, and Dr. Smith gives 
the preference to the latter. The following extract from the 
report will convey the opinions of some of our most eminent 
surgeons on the subject : 

" Dr. Paul Eve, the distinguished Professor of Surgery, in 
the Medical College of Georgia, furnishes a table of rlfty- 
four cases, in which chloroform was exclusively employed, 
with the most gratifying results. Four of these cases were 
of lithotomy. In some the anaesthetic influence was insuffi- 
cient, and in others too profound ; but nothing otherwise 
untoward occurred. 

" The chairman of this committee has administered chlo- 
roform to the degree of complete insensibility, no less than 



TRANS. AMERICAN MEt). ASSOCIATION. 193 

thirty-five times, to one individual, a delicate lady, in a case 
of periodical tonic spasm. Nothing unpleasant has resulted 
in any instance, further than occasional temporary, nervous 
prostration. The same individual has had recourse to this 
agent, in operative surgery, ahout fifty times; in all in- 
stances without any untoward results. 

" In a recent case of lithotomy on an idiot, a powerful 
young man, the operation could scarcely have been accom- 
plished without its aid, owing to his determined resistance. 
He was rendered perfectly manageable by its use ; no shock 
resulted, and his recovery was accomplished in two weeks. 

Professor Mott, although foremost in the bold enterprises 
which have distinguished American surgery, does not hesi- 
tate to declare, that he has recently successfully performed 
operations which he would not have hazarded without the 
aid of this agent. 

" Professor Parker, of New York, informs us that he de- 
cidedly prefers chloroform to ether. ' The action of these 
two agents,' he says, < is, I think, similar, but they stand in 
the relation of laudanum and paregoric to each other.' 

" Professor Mussey, of the Medical College of Cincinnati, 
informs us that he has employed the chloroform in a hun- 
dred cases, without witnessing a bad result in a single in- 
stance. He decidedly prefers it to ether. 

" Dr. D. M. Reese, resident Physician of the Bellevue 
Hospital, generally dreading too profound anaesthesia from 
pure chloroform, employs a mixture of chloroform and ether, 
equal parts. Occasionally, however, he has been compelled 
to have recourse to the pure chloroform, before sufficient 
insensibility could be obtained. He has witnessed no disas- 
trous consequences from its use. 

" Professor Gilbert, of Gettysburg, also employs a com- 
pound of these agents, but in the proportions of one of chlo- 
roform to seven of ether. His practice is founded on the 
belief, that chloroform is a sedative agent, and ether, stimu- 
lating. His experience in its use has been happy. 

" We should state that Prof. Knight, who is associated 
with us on this committee, does not fully concur with us on 
this point, preferring ether as an anaesthetic, dreading the 
too powerful effects of chloroform. 

" But our limits will not permit us to collate the reports, 
which on this subject, teem in the periodicals, both domestic 
and foreign ; and we have been obliged to omit the names 
of many, who have signalized themselves in this department 
of surgery. 
25 



194 TRANS. AMERICAN MED. ASSOCIATION. 

"Contemplating all the facts which, in relation to the use 
of anaesthetic agents, have been contributed during the past 
year, your committee congratulate the Association, on the 
great progress which has been made, in establishing profes- 
sional and public confidence in these extraordinary agents, 
and on the vast benefit which is likely to result to mankind, 
from this achievement of science and humanity. To them 
the recorded experience of surgeons, at home and abroad^ 
appears abundantly to justify the following conclusions. 

" 1st. The means of generally rendering patients insensi- 
ble to the pain of surgical operations, so long a desideratum, 
have at length been furnished in the anaesthetic agents sul- 
phuric ether, chloroform, and chloric ether. 

" 2d. The employment of these agents for obviating pain 
in most severe surgical operations is now not only justifia- 
ble, but the imperative duty of surgeons ; and, indeed, we 
may almost adopt the language of Prof. Miller, before the 
Medico.- Chirurg. Soc. of Edinburgh, that mo one among 
his surgical friends, would deem himself justified, morally 
or professionally, in now operating upon a patient in a wak- 
ing and sensitive state.' 

" 3d. Of the anaesthetic agents, chloroform is decidedly the 
most efficient and facile of respiration ; but, being most pow- 
erful, is, at the same time, most dangerous, when incau- 
tiously employed. 

"4th. In formidable and painful operations, chloroform 
not only obviates pain, but contributes to the safety of the 
patient, by preventing shock, and the irritation which is the 
antecedent and to a certain extent the cause of inflamma- 
tion. 

"5th. The use of chloroform is inadmissible in trivial cases,, 
because the danger from its use is greater than that from 
the operation. All must admit that, of the two objects to 
be held in view in a surgical operation, safety and immunity 
from pain, the former is the more important. 

" 6th. In regard to circumstances under which chloroform 
should be employed, we adopt the conclusions of the French 
Academy. ' It should not be used when there exists any 
disease of the heart, any aneurism near the heart, any threat- 
ening dyspnoea, any tendency to engorgement of lungs or 
brain. Care must be taken that, during the inhalation, at- 
mospheric air be sufficiently mixed with the vapour of chlo- 
roform, and that respiration be carried on freely. The in- 
halation should be suspended as soon as insensibility is ob- 
tained.' 



TRANS. AMERICAN MED. ASSOCIATION. 195 

" 7th. The best vehicle for the administration of chloro- 
form or ether, is a handkerchief or sponge of loose texture, 
through which the atmosphere may be copiously inhaled." 

The use of gutta percha is also mentioned as a substitute 
for the starch bandage in the treatment of fractures, though 
no reports upon its employment from American surgeons 
have as yet been presented, except by Drs. Smith and Wil- 
tenberger, of Baltimore, both of whom speak favorably of 
it. Dr. C. A. Pope, of St. Louis University, has employed 
collodion in the treatment of fractures in children : a strip of 
lint, he says, saturated with it, makes a convenient splint. 
The same gentleman has also tested " Jar vis' Adjuster," for 
reducing fractures and dislocations, and found it not to an- 
swer his expectations ; and the experience of the writer of 
the report fully concurs with that of Dr. Pope. We have 
not space to notice further this interesting report. 

The report of the committee on obstetrics, by Dr. Gilman, 
of New York, notices first, a few " subjects connected with 
the diseases of the non-pregnant female," among which are 
certain uterine displacements, and congestions and inflam- 
mations of the os and cervix uteri. The use of the specu- 
lum is warmly advocated, as affording the only positive 
means of correct diagnosis in the hidden diseases of the ute- 
rus, and the introduction of the instrument is claimed as an 
" important triumph of our art." The operation for the 
permanent cure of complete prolapsis uteri, which consists 
in the destruction with the knife, or actual cautery, of two 
or three longitudinal strips of the vaginal wall, is recom- 
mended as deserving of " more frequent and extended trials 
than it has yet received." The operation for occlusion of 
the vagina, as performed by Dr. A. P. Hayne, of Charleston, 
S. C, is also recommended. 

" The adhesions of the vaginal wall were broken up by 
the persevering use of compressed sponge, and at the end of 
ten weeks the canal became pervious, and the retained men- 
strual fluid, which had been collecting for more than a year, 



196 TRANS. AMERICAN MED. ASSOCIATION. 

was discharged ; the patient did perfectly well. This ope- 
ration, if hereafter found effectual, has obvious advantages; 
on the one hand, over the use of the knife, as avoiding the 
great danger of cutting into the bladder or rectum ; and on 
the other, over the operation by laceration, practised by 
Amussat, as inflicting much less pain, and producing 
less local and constitutional irritation. It deserves to be 
kept in mind as an available means of relieving cases of 
great danger and difficulty." 

The subject of detaching the placenta from the uterine 
wall, in cases of placenta prsevia, is presented and ably dis- 
cussed : the practice has been recently introduced by Prof. 
Simpson, of Edinburgh. It is advocated by Prof. S. on three 
distinct grounds. 

"1st. The old plan, of rupturing the membranes and 
turning the child, has been, according to recorded expe- 
rience, singularly unsuccessful, one in three of the mothers 
perishing, and the proportion of children saved being incon- 
siderable. 

"2d. In not a few cases, the rigidity of the os and cervix 
uteri renders the operation of turning exceedingly difficult ; 
indeed, almost impossible; and, when performed under such 
circumstances, it is nearly always and of necessity fatal. 

" 3d. The detachment of the placenta will, in the vast ma- 
jority of cases, immediately and effectually check the hem- 
orrhage." 

To the second proposition some exception is taken by the 
committee, though its truth is not denied. It is believed that 
" bleeding in quantities far below what is lost in placenta 
previa, is found in practice, so certainly, and so universally 
to remove rigidity" that there must be a state of the parts 
very different from their ordinary condition, to make the 
operation of turning " exceedingly difficult," viz : an unde- 
veloped cervix; as is the case in premature labor. When 
this condition exists, the committee consider the operation to 
be valuable, and are disposed to confine it to such cases. 
The third proposition is fully admitted, and upon the evi- 
dence of facts which sustain it, must stand the new practice, 
as there is abundant proof of the fact, that hemorrhage 



TRANS. AMERICAN MED. ASSOCIATION. 197 

in placenta praevia is materially checked by detaching the 
placental mass from the uterine wall. A considerable part 
of this report is also occupied with the subject of anesthesia 
in labor, and particularly in operative midwifery. After an 
impartial review of the whole matter, the dangers and the 
advantages being fairly considered, it is dismissed with the 
following observations : 

. " The use of anaesthetics, in operative midwifery, is de- 
fended not alone because they prevent physical pain, though 
that is a great advantage, pain always increasing the danger, 
and sometime directly destroying life, but because they fa- 
cilitate the operation. The extent to which the resistance 
of the patient impedes our efforts is known to all. None, 
but those who have had personal experience, can adequate- 
ly appreciate the advantage of having a patient, throughout 
a long and painful operation, perfectly passive. 

" The committe confidently believe that the operation is, 
in this way, robbed of half its difficulties. But this removal 
of obstacles from the path of the operator, though the com- 
mittee have been led somewhat accidentally to mention it 
first, is not the chief recommendation of the practice ; the 
recorded experience of Channing and others goes far to 
prove that the patient's chance of recovery is substantially 
increased, when she is saved the hour of agony. How, in- 
deed, can it be otherwise ? Who that has seen the ether- 
ized patient, after a severe and protracted operation, rouse 
from a state of unconsciousness, as from a refreshing sleep, 
and receive the announcement that all is over with a smile 
of wondering joy; who that has seen this, and compared it 
with the condition of her to whom this great boon has been 
denied, and who, after cries and screams of agony, and 
struggles that would not be controlled, has sunk sobbing 
and shuddering into a state of utter nervous exhaustion ; 
who that has seen this, can doubt, that, under such circum- 
stances, the chances of recovery are augmented by anaesthe- 
sia ? The committee deliberately believe that they are ; and 
that, in the more severe obstetric operations, not only may 
anaesthetics be rightfully given, but that they may not be 
rightfully withheld." 

So much space has been already occupied with a notice 

of the work before us, that we cannot devote any more time 
just now, to researches among its pages ; suffice it to say, 



198 PENNSYLVANIA HOSPITAL. 

that it is replete with valuable and varied information upon 
most subjects connected with medical science, and that it 
ought to be in the library of every physician who desires to 
keep pace with the current experience of medical writers, 
and to preserve an upward tendency in the constantly im- 
proving character of the profession. 



Report of the Pennsylvania Hospital for the Insane, for 
the year 1849. By Thomas S. Kirkbride, M. D., Physi- 
cian to the Institution. 

The annual visitation of Dr. Kirkbride's report is always 
acceptable; the one before us presents the institution over 
which he superintends, in a state of unprecedented prosperi- 
ty, additions have been made to the buildings, and a 
" patients cottage," a " ladies summer house," and a " mu- 
seum and reading room" have been erected, separately from 
the main building. Engravings of these improvements em- 
bellish the report . The following paragraph is all that we 
have room to extract ; it shows the view, past, present, and 
prospective, entertained of its capacity for usefulness, by Dr. 
Kirkbride. 

" In closing this, the ninth annual report, which it has 
been my duty to make to your board, it is no small satis- 
faction to be able to look back upon the past course of the 
institution, steadily increasing, as it has, in prosperity and 
usefulness, and now about to commence its tenth year, with 
a degree of efficiency greater than it has ever before possess- 
ed — its accommodations more extensive, and much improv- ■ 
ed in character — all its wards filled with patients, and, it is 
hoped, with a hold upon the sympathies of that community 
which has heretofore so liberally cherished it, that will lead 
to a steady increase of its resources, which, large as they 
may be, will ever find objects enough, to render aid to whom 
will be an act of the purest benevolence." 



COLLEGE OP PHYSICIANS OF PHILADELPHIA. 199 

Summary of the Transactions of the College of Physi- 
cians of Philadelphia, from Nov. 6, 1849, to January 
15, 1850, inclusive. 

There is a great deal of interest in the last report of the 
proceedings of the College of Physicians of Philadelphia, 
though our space will not admit of a very extended notice of 
it. An obituary notice of the late Dr. Thomas T. Hewson, 
was presented and read by Dr. Bache, at one of the meet- 
ings, and five hundred copies ordered to be printed for cir- 
culation. 

" Thomas Tickell Hewson was born in London, on the 
9th of April, 1773. He was the second son of William Hew- 
son, the celebrated anatomist and physiologist, who died of 
fever, occasioned by a wound received in dissection, on the 
1st of May, 1774, in the thirty -fifth year of his age, when 
the subject of this notice was but one year old. His mother 
was Mary Stevenson, daughter of Mrs. Margaret Stevenson, 
a widow lady, in whose house Dr. Franklin resided, while 
in London, as agent of the colony of Pennsylvania. She 
was a woman of cultivated mind and fine judgment. It was 
her good fortune to enjoy the friendship of Dr. Franklin to 
the day of his death ; and her published correspondence 
with him evinces as well the extent of her acquirements, as 
the elegance of her style. 

"In March, 1781, at the age of eight years, young Hew- 
son entered the school of William Gilpin, at Cheam, near 
London, where he received the rudiments of his education, 
and where he continued to reside until the summer of 1786, 
with the exception of five months in the winter 1784-85, 
which he spent with Dr. Franklin at Passy. He showed 
much aptitude for learning, and was called " little inquisi- 
tive Tom," and " all soul and no body." His mother, writ- 
ing to a friend in September, 1783, remarks of him that 'he 
bids fair, by the powers of his mind, to do honor to his 
name ; for he outstrips all his competitors in learning.' In 
the summer of 1776, Mrs. Hewson removed to America 
with her children, and soon after her arrival, Thomas enter- 
ed the Junior class of the College of Philadelphia, afterwards 
the University of Pennsylvania. He was prepared to grad- 
uate in 1788, but remained another year, in compliance with 
the advice of Dr. E wing, the Provost of the College, who 
wished him to postpone his graduation on account of his 



200 COLLEGE OP PHYSICIANS OP PHILADELPHIA. 

youth. In July, 1789, he took the degree of Bachelor of 
Arts, speaking at the commencement with much applause, 
and immediately afterwards he began his medical studies 
with Dr. John Foulke. After having pursued his studies 
for nearly five years in Philadelphia, he returned to England 
in June, 1794, and, in the month of September following, 
entered St. Bartholomew's Hospital, as one of the two house 
surgeons. In November, 1795, he went to Edinburgh, 
where he remained until July, 1796, when private business 
compelled him to return to London. In that city he was 
detained until July, 1800, when he returned to America. 
During his absence abroad, he had the misfortune to lose 
his mother, who died on the 14th of October, 1795, at Bris- 
tol, Pennsylvania, in the fifty-seventh year of her age." 

A period of eleven years was thus embraced in a course 
of medical and surgical studies, after which, he entered upon 
the practice of his profession, in Philadelphia. He served 
as physician to the Walnut street prison, as one of the sur- 
geons of the Philadelphia alms-house, and as physician to the 
Orphan asylum. During the epidemic prevalence of the 
yellow fever in 1820, Drs. Hewson and Chapman offered 
their services to the Board of Health, to attend the yellow 
fever hospital. In 1822, he established a private school, 
where he delivered an annual course of lectures on anato- 
my. In 1832, he was chosen a member, and elected presi- 
dent of the " Cholera Medical Board," in which capacity he 
visited daily the city hospitals, and was ever ready to afford 
assistance when his services were required. He served also, 
as consulting surgeon to the Philadelphia Dispensary, for 
many years. At the time of his death, he was president of 
the College of Physicians, which office he filled with a dig- 
nity and urbanity of manners which is still fresh in the mem- 
ory of his surviving fellows. Dr. Hewson left no formal pub- 
lication of his several treatises, though he contributed fre- 
quently to the medical periodicals of his day. 

" For the last three years of his life, Dr. Hewson suffered 
from uneasiness about the neck of the bladder, which caused 
the motion of his carriage to give him considerable pain. 
From time to time, especially after fatigue or exposure to 



COLLEGE OF PHYSICIANS OF PHILADELPHIA. 201 

sudden changes of temperature, his usual symptoms were 
aggravated, and he suffered painful attacks, attended with 
haematuria. The chief cause of his sufferings was ascer- 
tained to be an enlargement of the prostate, which, in con- 
nexion with the morbid condition of the bladder, sufficient- 
ly explained his symptoms. About two weeks before his 
death, he was seized with an attack of his disease, more se- 
vere than on any previous occasion. Thirty-six hours be- 
fore dissolution, he became somewhat comatose ; but up to 
that time his intellect had been perfectly unclouded ; and 
though fully aware of the approach of death, he manifested 
the most perfect calmness and resignation. The fatal event 
took place on the 17th day of February, 1848, in the seven- 
ty-fifth year of his age, after an honorable career of profes- 
sional exertion of nearly fifty years." 

At one of the meetings of the college, an interesting dis- 
cussion occurred on the subject of pulmonary consumption, 
its pathology, treatment, and curability. Dr. Roifrey of 
Paris, who was present by invitation, was requested to give 
his views upon the subject. 

" Dr. Roifrey remarked, that he found the views of the 
medical men of Philadelphia, in relation to consumption, 
more advanced, and more in accordance with what he con- 
sidered sound practical experience, than those entertained 
by physicians elsewhere. In Paris there were still many 
practitioners who regard phthisis as an inflammatory disease, 
and keep their patients confined to their rooms and on low 
diet. Medicines are still in vogue, such as iodine, digitalis, 
&c., which can produce only a temporary effect upon the 
symptoms without touching the source of the disease ; they 
cannot improve the nutrition of the body, which is the grand 
object to be aimed at. In France, Dr. R's. opinions on this 
disease were considered peculiar, but here he finds them 
prevalent, and amply confirmed by the experience of the 
leading members of the profession. 

" Dr. Riofrey referred to a series of papers on consump- 
tion by the late Dr. Joseph Parrish, which were published 
in the year 1829, '30, in the North American Medical and 
Surgical Journal. These papers he looked upon as present- 
ing the most correct views in relation to the pathology and 
treatment of the disease in question." 

In these papers, the old idea of tubercles being the result 
26 



202 COLLEGE OF PHYSICIANS OF PHILADELPHIA. 

of inflammation, is discarded ; they are held to be the resuU 
of insufficient nutrition, &c.; an intimate relation is shown to 
exist between scrofula and consumption, and the importance 
of favoring the appearance of external scrofula, rather than 
dispersing it by local applications, is given as one means of 
diverting the disease from the lungs ; while by improving 
the nutrition, by free exercise in pure air, good diet, &c, 
much may be done to eradicate the tendency to phthisis. 

" In his investigations into the curability of consumption, 
a subject which has occupied much of his attention of late 
years, Dr. R. has found that all the recoveries from the dis- 
ease have taken place under an invigorating plan, having 
for its object the improvement of the nutrition. It is upon 
this principle that the cod liver oil acts. It is an aliment 
easily assimilated, and gives to the constitution the elements 
which are wanting. Dr. Riofrey was among the first phy- 
sicians to employ this article in consumption. He com- 
menced its use in London, in 1835, from having heard of its 
good effects through Dr. Pearson, of that city, who was 
using it in chronic rheumatism with great advantage. Its 
utility in scrofulous complaints, was first inferred, from the 
fact of the liver of the cod, being extensively employed as a 
domestic remedy in these affections in some parts of Ger- 
many. Mothers there give it to delicate children, without 
the advice of the physician, and find that they grow fat un= 
der its use. As the liver of the cod contains a large amount 
of oil, it was inferred that its remedial powers were attribu- 
table to it, and hence the oil was extracted and brought into 
general use." 

The remarks of several Fellows are reported as favoring 
this doctrine, and Dr. Riofrey stated in addition to the quo- 
tation already noticed with reference to cod liver oil, that it 
was not simply as a medicine, but as an alimentation, that 
he recommended its use ; " he did not believe it was the 
small portion of bromine or iodine contained in it, which 
rendered it useful, but rather its capacity of being rapidly 
assimilated, and of making fat." 

We must desist from any further extracts from this valu- 
able work : time and want of space admonishes us to do so. 



NEW JERSEY MEDICAL REPORTER. 

BURLINGTON, FOURTH MONTH (APRIL,) 1850. 



EDITORIAL. 



SCIENTIFIC MEDICINE txrsus QUACKERY. 

As petitions from several sections of the state, were present- 
ed to our last legislature, for the repeal of the medical law, 
it becomes us briefly to notice the subject in our journal. 
These attacks upon the welfare of the community emanate 
generally from those who are interested, not in the science of 
medicine, not in the health and prosperity of our citizens, 
not in the stability of our institutions, but in the success of 
their own private plans, and in the overthrow of customs 
which have contributed largely to the preservation of the 
people from imposition and fraud, from the time of our pro- 
vincial existence. The petty medical schools of other states, 
where there are no legal restrictions to impose any sort of 
qualification upon either teachers, or pupils, turn out year 
after year, scores of graduates in medicine, who, failing 
in ability to compete with intelligent and conscientious 
practitioners, and wanting in honest principle to confess 
their ignorance, adopt such names as our laws do not re- 
cognize, and then ask our legislators to frame a statute to 
legalize their ignorance, and confirm their pretended compe- 
tency. We venture to assert, that no man, who by a course 
of protracted study, has qualified himself to enter the field of 
medical practice, and who has graduated fairly and honora- 
bly in a medical college of any reputation, will feel afraid 
to meet a New Jersey board of examiners; not one but 
would feel himself fortified by additional authority to prac- 
tice his calling in our midst, by procuring a "license" 



204 EDITORIAL. 

from the only acknowledged medical authority among us. 
If it is pretended that the usual course of instruction in anat- 
omy, physiology, chemistry, materia medica, surgery, obste- 
trics, &c., is not necessary to qualify a homoeopathic, botan- 
ic, or eclectic doctor, to practice medicine, then do they dis- 
arm themselves at once of the means of obtaining public con- 
fidence. If on the other hand, they admit such a course of 
instruction to be necessary, and have complied with it, why 
do they shrink from the legal test — the application of which 
is necessary to ensure legal protection. It is asserted then, 
without fear of contradiction, that these petitions are origina- 
ted by men who are ignorant of the true principles of medi- 
cal science, (it may be otherwise with a few who are actu- 
ated by prejudice or selfish motives,) and that being indus- 
triously circulated, they are signed by those who are still 
more ignorant of what are the necessary qualifications for a 
safe practitioner of medicine. The people, we know, will 
judge for themselves ; they make up their minds, that this 
or that system is the most likely to ensure their recovery 
when sick, and adopt their choice. The right to do this, 
is granted of course ; but the science of medicine is 
purely demonstrative, and hence, a judgment of its true 
character cannot be founded upon any other basis than that 
of demonstration. The people cannot, in the nature of things, 
possess this means of discriminating between the true and 
false ; hence their judgment is necessarily defective, and 
though it may sometimes be true as the result of observa- 
tion and induction, it cannot be really correct without a 
course of careful study. 

Physicians who are properly educated in the science of 
medicine, whether they be of this, or that notion, in regard 
to its practical application, will have no fear of a fair exam- 
ination, upon the principles and basis of the science ; and 
whenever those who pretend to be qualified, shrink from an 
investigation by a legally constituted board, it is fair to judge 
that they know themselves to be deficient in that knowledge. 



EDITORIAL. 205 

the possession of which is absolutely necessary to constitute 
a safe practitioner of medicine, whether he appears before 
the public as a Homoeopathist, a Thomsonian, or one of the 
new school of Eclectics. If this position is denied by those 
who desire the repeal of the medical law, then do they a- 
bandon the position that their several systems are based 
upon scientific principles, and assume the doctrine which 
we believe to be true, that they are pursuing a mere trade, 
for the sake of gain. 



COLLODION, AND COLLODIUM CANTHARIDAL. 

Collodion. — We acknowledge the receipt, from our bro- 
ther, t Edward Parrish, Apothecary, N. W. corner Ninth and 
Chestnut Sts. Philadelphia, of a specimen of Collodion, of his 
preparation, which possesses the adhesive and contractile pro- 
perty of that article in a marked degree. It is made accord- 
ing to the most approved formula ; that, adopted we believe, 
by the Philadelphia College of Pharmacy, and incorporated 
in the revised edition of the U. S. Pharmacopoeia, to be pre- 
sented by the College to the ensuing meeting of the National 
Pharmaceutical Convention, to be held in Washington. 

Collodium Cantharidal. — This is a preparation for 
blistering, — blistering Collodion. It is prepared by treating 
powdered Spanish flies, with ether, by the displacement pro- 
cess, so as to form a concentrated solution of cantharadin ; — 
in this, a proper proportion of prepared cotton, which is the 
base of collodion, is dissolved. It renders the solution viscid, 
and imparts to it, its peculiar adhesive property. All that is 
necessary to produce vesciation with this article, is to paint 
it over the surface to be blistered ; after the lapse of about 
the usual time for a common blistering plaster, the full effect 
will be produced. We have used it, and find it to answer 
the purpose admirably ; the convenience of its application, 
no cloth, adhesive strips or bandages being required to keep 
it in its place, as well as its extreme portability, recommend 



206 EDITORIAL. 

it as preferable to the ordinary blistering ointment. It may 
be applied to any part of the body without the fear of being 
rubbed off, by position, or the friction of clothing. And if it 
be required to produce speedy vescication, it can be readily 
accomplished by covering the part immediately, with oiled 
silk, or other similar material, by which the evaporation of 
ether is prevented, and the rapidity of its operation increas- 
ed. We would recommend it to the practitioner in the 
country as a much more portable, and less disagreeable ar- 
ticle to carry about his person, than the common blistering 
salve r 



TILDEN & CO.'S MEDICINAL EXTRACTS. 

We have received from Tilden & Co., of New Lebanon, 
New York, a package of medicinal extracts of very fine 
quality, which we take pleasure in noticing, especially as 
they are productions of our own country. As many of our 
readers are aware, we have been indebted to English Phar- 
maceutists for our best medicinal extracts, until a very re- 
cent period. 

The firm of Tilden & Co. we believe, were the first to pro- 
duce certain kinds of extracts of unexceptionable quality, on 
this side the Atlantic, and we hope their enterprize will be 
well repaid. A pharmaceutical friend informs us that the 
difficulty attendant upon the inspissation of vegetable juices, 
disposing them to decompose and become insoluble and 
compartively inert, is mainly due, to too great an elevation of 
temperature during the process, and to the oxidizing influ- 
ence of the atmosphere when present. 

The construction of an apparatus for evaporation in vacuo, 
is then a desideratum in an establishment for the maunfacture 
of vegetable extracts, and it is for this improvement that Til- 
den & Co. are deserving of encouragement. The juices are 
pressed from the fresh plant, together with an alcoholic in- 
fusion of the pulpy mass left; after submitting the plant to 
pressure, it is placed in a large air-tight boiler, connected with 



EDITORIAL. 207 

an air pump, worked by steam power, and the atmosphere 
being exhausted, and a heat of about 100° to 180° being ap- 
plied to the boiler by means of steam pipes, the whole liquid 
boils violently, and the vapour being condensed, is drawn 
off by appropriate arrangements ; so that by this means a 
very thick liquid is obtained, which is then exposed in shal- 
low dishes, in a good draft of dry air, until sufficiently in- 
spissated to be thrown into commerce. 

The Extracts thus obtained, are found to contain the ac- 
tive principles of the plant unaltered, their chief disadvan- 
tage being, that they are too thin to form a pillular mass 
without a further inspissation, or the addition of some extra- 
neous matter; — as in most cases the dose of these extracts is 
small, this difficulty is easily overcome, and as the tendency 
of the extract upon being kept, is to get harder, it is not so 
objectionable as the other extreme, when accomplished by 
prolonging the application of heat so as to dissipate some of 
the volatile principles. One of the finest ot the specimens 
sent is the extract of Conium, which possesses the peculiar 
odor of its volatile active ingredient, in a degree that we 
have never before observed. We are informed that this, 
and the other narcotic extracts have been fully tried, and 
found very efficient preparations, which is more than can be 
said for most specimens in ordinary use. 

C. D. Knight, N. Sixth Street, below Arch, is the Phila- 
delphia Agent. They may also be obtained of E. Parrish, 
corner of Ninth and Chestnut Streets, Philadelphia. 



THE BENEVOLENT FUND. 
The able report, read by Dr. Gibbon, of Salem, at the late 
semi-annual meeting of the New Jersey Medical Society, 
and published in the last number of this Journal, on the sub- 
ject of " establishing a fund for the relief of the families of 
such regularly licensed physicians throughout the State, as 
may hereafter die in indigent circumstances," is before the 
profession. The committee to whom the subject was en- 



208 EDITORIAL. 

trusted, have clearly shown that such a measure was prac- 
ticable; and as the matter will be brought up for discussion, 
and probably for decision, at the ensuing annual meeting, it 
is desirable that Fellows, and delegates should go prepared 
to act upon it; we therefore take the liberty of bringing it to 
their notice. Of the propriety of establishing the fund, we 
cannot think there will exist a doubt — but whether the pro- 
posed charity shall be incorporated with the medical society, 
or organized as a separate institution, is the question to be 
settled. Each view of the case has its advocates. To re- 
move the objection which existed in the fact, that in the 
charter of the society, no powers are granted for the estab- 
lishment of such a fund, a supplement has been appended 
to it, by the last legislature, which gives the right, should it 
be deemed expedient to exercise it. 



NEW MEDICAL PUBLICATIONS. 

The St. Louis Probe — A new monthly, of twenty-four 
pages, comes to us in a neat unpretending form, and has 
won our friendship. We are glad to welcome it among our 
exchanges. It is edited by A. J. Coons, M. D. and John R. 
Atkinson, M. D. We hope the gentlemen who have un- 
dertaken the editorial charge of the Journal may have no 
reason to regret it, while we have no doubt that their sub- 
scribers will be amply compensated in the quality and 
amount of information, thrown before them. 

The Northern Lancet and Gazette of Legal Medicine. — 
Two numbers of this journal, edited by Francis J. D' Avig- 
non, M. D. and Horace Nelson, M. D., have reached us. 
" Truth without fear," is the motto which appears upon the 
title page. In addition to varied intelligence upon numer- 
ous scientific subjects, there will be a department allotted to 
"memoirs of celebrated European and American Physi- 
cians." It will be issued monthly at one dollar per annum. 
We enroll it among our exchanges. 



ECLECTIC DEPARTMENT. 



Observations on Collodion, in the Treatment of Skin Dis- 
eases. By Erasmus Wilson. — (Lancet, Nov. 1848.) 

" It is now about four months since a solution of gun-cot- 
ton in sulphuric ether (collodion) was placed in my hands 
by Messrs. Bell, of Oxford street, and since I first proceeded 
to employ it in the treatment of cutaneous diseases. I was 
at that time much interested in the medical progress of a 
young lady (the daughter of a physician in the west of En- 
gland) who had been suffering for many years with scrofu- 
lous ulceration in various parts of the body. She had been 
under my care for several months, and the sores were much 
improved, but they were, nevertheless, very far from being 
healed. The diseased skin had the appearance of being 
worm-eaten, its hollows were filled with pus, which bur- 
rowed under the surface, and it was, moreover, thickened 
and congealed. By the constitutional treatment which I had 
pursued, I had, to a considerable degree, corrected the pyo- 
genic tendency of her system ; but I felt the want of a local 
remedy that would serve as an impermeable covering to the 
surface — in fact, take the place of the lost epidermis, and act 
the part of an artificial scarf-skin. I had tried vulcanized 
caoutchouc spread with adhesive plaster, gutta percha, ni- 
trate of silver, astringent solutions, ointments, and pressure 
by bandage, in vain — the remedy was not yet found. 1 was 
revolving this difficulty in my mind when the collodion was 
put into my hand. The bearer of the little bottle may re- 
member my exclamation, "that was exactly the thing 1 
wanted." 

On the next visit of my patient, I removed the dressings 
from the sores, and pencilled them over with the new agent, 
which covered the surface with a powerful adhesive film, 
about the thickness of gold-beaters' skin, and effectually re- 
presented the lost scarf skin. A piece of dry, soft linen was 
the only additional covering required, and she left me, much 
delighted at the abandonment of the local applications and 
bandages. This young lady has since continued to apply 
the collodion herself, night and morning, until the present 
27 



210 COLLODION IN SKIN DISEASES. 

time, when the sores are nearly well, and the congestion 
and scrofulous thickening of the skin almost gone. 

From careful observation of the effects of collodion in this 
case, I found it to possess four important properties — namely, 

First. That of a mild stimulant. 

Second. That of an efficient substitute for the natural 
scarf-skin. 

Third. That of a mechanical compress. 

Fourth. That of an adhesive glue, from which quality it 
derives its name. 

First. As a mild stimulant, it is fitted to exert a local al- 
terative action on the congested capillaries of a chronic ul- 
ceration, and give activity to the healing process. 

Second. In its character of a substitute for the absent 
scarf-skin, it is transparent, plain, and more or less imper- 
meable, according to the thickness of the layer that may 
seem to be required. 

Third. Its most remarkable property, as it seems to me, 
is the contraction which occurs during the dessication of the 
collodion, and which produces a local pressure of considera- 
ble power on the surface to which it is applied. Thus, in 
the case above related, the congestion of the thickened skin 
was relieved by the varnish-like film of collodion spread 
upon its surface, by means of a camels-hair brush, as com- 
pletely as if a nicely adjusted bandage had been placed over 
it. In another instance, I found a film of collodion entirely 
remove a purple congestion (resulting from imperfect circu- 
lation) from the tip of the nose, in a lady who had long suf- 
fered from the annoyance. In a third case, in which the 
fingers of an elderly lady were congested and blue, and the 
congestion was attended by pain and throbbing, like that 
which accompanies chilblains, the collodion produced so 
much contraction as to render their tips white and bloodless, 
and I was obliged to discontinue the application in conse- 
quence. 

Fourthly. The glue-like property of the collodion is evinced 
in its adhesion of cut surfaces, a property which is much in- 
creased by the contraction above mentioned. When em- 
ployed with the purpose of keeping together the edges of an 
incision, a piece of cambric or thin linen rag should be dip- 
ped in the solution, and placed along the line of incision, 
after the cut edges have been adjusted and carefully dried, 
perfect dryness of the skin being a necessary condition to 
the adhesion of the solution. From the rapidity with which 



COLLODION IN SKIN DISEASES. 211 

the solution dries, and its perfect adhesive power, collodion 
is likely to occupy an important place among the "adjuvan- 
tia" of surgical practice. 

The diseases of the skin in which I have hitherto used the 
collodion with advantage are, chronic erythema of the face ; 
interrigo; chapped nipples and chapped hands; herpes labia- 
lis, preputialis, and herpes zoster ; lichen agrius ; lupus non 
exedens and exedens; acne vulgaris; and several affections 
of the sebiparous organs. In chronic erythema of the face, 
its contracting power was most usefully evinced, as it was 
also in lupus non exedens and acne. 

In a troublesome case of chapped hands and fingers, re- 
suiting from chronic lichen agrius, the collodion acted, not 
merely as a protective covering, but also promoted the heal- 
ing of the cracks more quickly than the remedies I have 
been in the habit of employing. In chapped nipples, it was 
even more efficient in its protective and curative action, and 
seemed, in the two instances in which I used it, to work a 
charm upon the painful skin. The gaping cracks were in- 
stantly drawn together and almost obliterated by the con- 
tracting power of the remedy, and were effectually shielded 
from the influence of moisture and pressure of the gums of 
the infant, and all this, in consequence of the rapid evapora- 
tion of the ether, in an instant of time. In another point of 
view, the remedy is invaluable as an application to chapped 
nipples — namely, as being in no wise injurious to the infant, 
from offering nothing which can be removed by the lips dur- 
ing the act of sucking, and in this particular, therefore, pos- 
sessing a vast superiority over the various forms of oint- 
ments, astringent lotions, &c. 

In four instances, it immediately put a stop to herpes labi- 
alis, and in a very severe attack, it showed itself to be a 
powerful and useful remedy. Small superficial ulcerations 
of the corona glandis and prepuce, caused by excoriation, 
were cured by a single application, and in a gentleman very 
susceptible of excoriation it acted admirably as a prophylac- 
tic. From the success of the latter trial, I am inclined to 
think that it might be successfully employed as a prophylac- 
tic, in cases of exposure to syphilitic contagion. 

When properly applied, the collodion enters all the cre- 
vices of the lines of motion, of the skin, and adheres so firmly 
as to require several washings for its removal. As it is 
usually prepared, it has the consistence of syrup, and in this 
state is best suited fox those cases in which its adhesive pro- 



212 BROWN ON HEMORRHOIDAL TTJMORS. 

perties are principally needed. Where, however, it is need- 
ed to be applied to the surface of an ulcer or abrasion, or to 
chaps of the skin, I find it convenient to dilute with ether, 
and render it almost as limpid as water, 

In pursuing this subject, I have made trial of a solution of 
gutta percha in chloroform, and also in benzole, but these 
solutions are very inferior to the collodion, for the purposes 
above named. Their adhesive powers are weaker than the 
collodion, and the layer which they form when painted on 
the skin, is apt to rise at the edges, and rub off. — Charles- 
ton Med. Journal. 



Case of Hemorrhoidal Tumours and Prolapsus Ani, 
Treated by Nitric rfcid— By B. S. Brown, M. D. of 
Bellefontaine, Ohio. 

In September 1848, 1 was called to visit Mrs. P., a mar- 
ried woman, aged about forty years ; she was weak, nervous 
and emaciated, confined entirely to her bed, by the irritating 
and debilitating effects of large hemorrhoidal tumors and 
prolapsus ani — about six months previously, my advice had 
been asked in regard to her case, at which time I was told of 
the frequent prolapsus, and directed her ahvays to reduce it 
whenever it came down, and recommended astringent ap- 
plications, &c, — I did not then examine the parts. When I 
visited her in September, she told me that she had not had 
a passage from the bowels for more than six months with- 
out the piles as she called them, coming down : but, that 
she had always put them up immediately — that they would 
frequently come down when she was walking about, and 
that it gave her a great deal of trouble to keep them up. 
For several weeks past they had been severely painful, and 
she had not been able to leave her bed, indeed to use her 
own words, they were " worrying her life out of her." She 
wished me to attempt a permanent cure by an operation, 
and told me I must attempt it, even if the operation should 
kill her — for she would rather die in the attempt to be cured, 
than live in her present situation. I made an examination, 
for she could at will force down the whole mass. Altogeth- 
er it was rather a frightful looking object; the whole was 
more than half the size of a man's fist, the lower part of the 
rectum seemed to be everted all round and much inflamed 
and swollen. Besides there were several large tumours 
growing from its surface, very vascular, and disposed to 



BROWN ON HEMORRHOIDAL TUMORS. 2 13 

bleed upon slight abrasion. She assured me it had remain- 
ed in this situation for many months ; in addition to this, she 
had been attacked with intermittent fever some days before, 
which increased her debility, and nervous irritability — I told 
her I thought best to break the ague first, and afterwards I 
would endeavor to relieve her distress by an operation. I 
prescribed quinine, morphine, wine, &c, which in a few 
days arrested the intermittent ; I then determined to operate, 
and fixed the day. 

On the 25th September, having taken to my assistance 
my friend, Dr. Lord, we visited the patient. When she had 
by straining, as before, forced down the mass, we found the 
parts much in the same condition as when I had previously 
seen them. From the number and size of the tumours, their 
great vascularity, and the inflamed condition of the sur- 
rounding parts, we feared the knife on account of the hazard 
of hemorrhage. The ligature or ligatures, (for they would 
have to be many,) we thought would produce so much pain 
and irritation as to be equally inadmissible. We therefore 
concluded to try the nitric acid, as recommended by Dr. 
Houston, of Dublin, Ireland. We used the purest nit: acid 
we could obtain. The patient was laid on the side, in a bent 
position, with the hips close to the edge of the bed, so as to 
bring the parts as fully into view as possible. 

We applied the acid by means of a piece of silk or cotton, 
rolled up tightly, so as to form a small mop, resembling a 
blunt camel's hair pencil. It was applied freely to all parts 
of the tumors that were exposed, and to many parts of the 
inflamed mucous membrane, care being taken not to use the 
acid so profusely, as to have it run on any pajt not intended 
to be touched. After the acid was allowed to remain three 
or four minutes, the whole of the parts were well smeared 
with soft lard, and carefully pressed back within the sphinc- 
ter. An opiate was administered, and directions given to 
take opium every night for three nights, as well to prevent 
an evacuation from the bowels within that time, as to pro- 
cure rest and allay irritation. She was directed to take a 
full dose of castor oil on the fourth morning, at a particular 
hour, so that I could visit her an hour after, when it would 
probably operate, as I still had some fears of bleeding when 
the sloughs should separate. 

When I arrived, however, the medicine had already ope- 
rated ; and with the evacuation the sloughs had come away, 
and there was but little protrusion, and no hemorrhage; 



214 HARTSHORNE ON MANIA-A-POTU. 

though the sloughs had considerably the appearance of clot- 
ted blood, filling the interstices of the cellular membrane. 

As a small portion of the tumors were not destroyed, I 
applied the acid again, in the same way and with the same 
directions ; I indeed had to make a slight application the 
third time ; but after that the cure appeared to be effectual 
and permanent. She had no pain, and had the usual evacu- 
ation of the bowels without any thing coming down. More 
than a year has now elapsed, and she remains well in that 
particular. 

From the results in this case, I look upon this compara- 
tively new method of treating such cases as a great acces- 
sion to our art, as it seems to be entirely safe — is effectual — 
and attended with but little pain. In this case the patient 
declared that the pain was not more severe than she had a 
thousand times felt before, in these tender, irritable tumors 
when no application was affecting them. The strong nitric 
acid seems to destroy the life of the part it touches, so in- 
stantaneously, that the pain is much less than might be sup- 
posed. Again, I have no doubt of its safety, as in this case 
there was no hemorrhage when the sloughs came away; and 
they left a clean, healthy looking surface, that healed over 
in a much shorter time than I could have imagined possible. 
— Ohio Med. and Surg. Journal. 



Treatment of Mania-a.potu in the Pennsylvania Hos- 
pital — By Henry Hartshorne, M. D. 

Mania-a-potu. — In the summer of 1847, twenty-six cases 
of delirium tremens were treated under the direction of Dr. 
Pepper, without any death. The only failure of complete 
recovery, was in a man very much broken down by disease 
of the liver, &c, for which he was admitted, and who was 
removed by his friends. In one respect, this class of patients 
suffered under a disadvantage ; they were, while ill, neces- 
sarily confined to their rooms, many of which, being in the 
basement, were too gloomy not to feed the dismal delusions 
and fears to which they were subject. There is no doubt 
that the most appropriate place for the management of such 
cases, would be a ward furnished with the space, attendance, 
and other conveniences and comforts of a well regulated lu- 
natic asylum; such, for instance, as the insane department 
of the Pennsylvania Hospital, Blockley. 

In spite of these difficulties, however, the mortality in the 



HARTSHORNE ON MANIA- A-FOTU 215 

wards in the city Institution is small. The usual treatment 
has been a combination of the moderate opiate, with the 
stimulant plan, varied according to the case. In merely 
mild or threatening instances, exercise such as was attaina- 
ble, one or two bottles of porter daily, with full diet, and a 
Dover's powder or other soporific at night, proved sufficient. 
When the nervous symptoms were well developed, but the 
pulse, warmth of skin, condition of stomach and muscular 
capacity evinced the absence of prostration, one grain of 
opium every two or three hours was given, perhaps with 
wormwood tea, but without alcohol, unless the patient was 
known to have been habitually a large drinker. If the skin 
became cold and clammy, the pulse rapid and small, and 
long vigilance produced general exhaustion, brandy was di- 
rected, to the amount of a table spoonful every hour or two, 
and one grain of opium was given every hour as a maxi- 
mum. This course rarely failed to produce sound and pro- 
longed sleep in from one to three or four days ; and the sleep 
was almost invariably followed by immediate recovery. In 
several cases a blister to the nucha shortened an obstinate 
attack. Laxatives were required by a number. Intractable 
vomiting and rejection of food gave trouble frequently, but 
were subdued by the usual means. The most tedious case 

was that of a young lawyer, M , whose symptoms, 

from the first, were less violent than the average; but who 
continued rather to lose than gain for three weeks, having 
the ordinary delusions constantly, with some tremor and in- 
creasing wakefulness. After having increased his anodyne 
to the amount of two grains of opium every two hours with- 
out effect, Dr. Pepper substituted the following: R. tinct. va- 
lerian, 5iij; liq. morph. sulph. 3SS. M. S. q. h. quart.; and di- 
rected also an enema of a drachm of laudanum every night. 
His first long sleep, the precursor of cure, took place after a 
warm hath, the head being at the same time placed for some 
minutes under the cold stream of the hydrant. 

In the course of two years under observation, some fatal 
cases of mania-a-potu occurred, chiefly in connection with 
violent injuries. But, whatever may be said of the success 
of the simple alcoholic plan in other institutions, or of the 
excessive narcotic treatment formerly in vogue, there ap- 
peared to be every reason to be satisfied with the combina- 
tion of the use of moderate doses of opium with stimulation 
proportioned to the asthenia of the case. 

The mode of termination of one fatal case was remarked 



216 MUCOUS MEMBRANE IN CHOLERA. 

particularly. Patrick Riley, cab driver, was admitted 6th 
mo., 11th, 1847. He was evidently delirious, but passive, 
and not noisy. He had been bled by a physician out of 
doors, on account of more violent symptoms. The pulse was, 
on his entrance, somewhat feeble, and the skin cool. We 
gave him at once an ounce of brandy — his usual beverage — 
and thirty drops of laudanum. The watchman was direct- 
ed to give him twenty drops more in the night, with half an 
ounce of brandy, if he continued sleepless. 

I was called early in the morning to see him, in a coma- 
tose condition ; face livid ; respiration at long intervals, and 
stertorous ; skin warm ; pulse rapid, and somewhat full. The 
physiognomy and breathing were exactly those of fatal nar- 
cotism from opium. Cold was freely applied to the head, 
and cathartic injections thrown into the bowels, while the 
feet were surrounded with sinapisms ; but he died in the 
course of the day. 

It was impossible that ordinal narcotism could have been 
produced to such an extent by fifty drops of laudanum, in 
two doses. The fidelity and care of the watchman could 
not be doubted. The disease itself must have imitated the 
action of opium. Dr. Pepper pronounced this opinion deci- 
dedly; and confirmed it by reference to a case mentioned in 
Watson's Practice, almost exactly similar in all respects — 
the man having been bled, and then having swallowed three 
grains of opium, died with all the symptoms of laudanum 
poisoning. Dr. Watson considered the universal experience 
of the tolerance of opium in mania-a-potu, to prove plainly 
that the disease had spontaneously assumed that mode of 
termination. — American Journal. 



Report of the Committee appointed to examine into the 
condition of the mucous membrane of the intestinal ca- 
nal in persons dying of Cholera. 

Science is positive only when its facts are positive. A 
subject, the phenomena of which are numerous and com- 
plex, can be understood only when each of its phenomena 
or facts have been analysed, and positively ascertained. 

In Epidemic Cholera, the most prominent and constant 
phenomena, are purging and vomiting: and in ninety or 
more, of one hundred cases, these phenomena appear to in- 
duce the condition that usually terminates fatally. 



MUCOUS MEMBRANE IN CHOLERA. 217 

It is, therefore, an important object in determining the phe- 
nomena of cholera, to ascertain whether any, and if any, 
what constant anatomical alterations can be detected in the 
intestinal canal of cholera patients who have succumbed un- 
der the disease. 

The College, with the view to obtain, as far as possible, 
accurate information on this single question, appointed the 
undersigned, at the meeting held on the 19th day of June 
last, a committee to investigate this subject. 

The Committee having attended to this duty, submit the 
following report : 

The ordinary autopsical examinations, heretofore practis- 
ed, have failed to yield any satisfactory information, and are 
nearly useless for the purposes of science. 

Extensive structural lesions may exist, that cannot be 
seen, or very imperfectly discerned by the unaided sight, 
and without proper preparation. 

It was determined by the Committee that the intestines, 
before being submitted to examination, should be finely in- 
jected, and subsequently inspected with the microscope. 
■*- This task was undertaken for the committee, by Dr. John 
Neill, demonstrator of Anatomy in the University of Penn- 
sylvania. The admirable manner in which he has perform- 
ed this duty, can be judged of by the beautiful preparations 
now on the table, which he has presented to the College for 
its museum. 

The injections are made with turpentine colored with Ver- 
million. It was found by Dr. Neill, that when he employed 
size, it did not penetrate well, and numbers of capillaries 
were not filled ; the same result occurred when Canada Bal- 
sam was used. It led, at first, to the supposition that the 
capillaries were destroyed by the disease. 

The committee, confining themselves strictly to the single 
object for which they were appointed, report the following 
facts as the result of their investigation : 

1st. In the recent subject, the peritoneal coat, like all the 
serous membranes, was in all, remarkably dry. The lubri- 
cating serosity is deficient in the serous membranes. 

2nd. The epithelial layer of the intestinal mucous mem- 
brane, was, in all the specimens, either entirely removed, or 
was detached, adhering loosely as a pulpy layer, mixed with 
mucus, or an albuminoid substance. 

3d. Peyerian Glands. Peyer's Glands were developed 
to a greater or less extent in all the cases examined. 
28 



118 IODINE IN CHOLERA. 

4th. Solitary Glands, These were also developed, and 
contained, in the recent subject, a minute quantity of white 
substance. These enlarged solitary glands have the appear- 
ances designated by Serres and Nonat, as Psorenterie. 

The villi covering the glands of Peyer, and the solitary 
glands present the same appearances as in other parts of 
the same intestine. 

5th. Villi. They are denuded of the epithelial covering, 
but are unchanged in other respects. 

6th. Capillary Vessels. These are entire, and manifest 
no departure from their normal state. The appearances of 
the capillaries of a cholera intestine, are identical with those 
of the healthy mucous membrane when the epithelium has 
been removed. In the natural state, the epithelium, from 
its thickness, conceals the injected capillaries. 

In no instance was a vesicular eruption observed. _ In 
some of the dry specimens, there is an appearance that might 
be mistaken for it, but it is an emphysematous state, result- 
ing from commencing putrefaction. 

The foregoing facts are derived from the examination of 
twenty -five subjects. 

Samuel Jackson, M. D. 
John Neill, M. D. 
Henry H. Smith, M. D. 
William Pepper, M. D. 
— Trans. Philada. College of Physicians. 



The Topical Use of Iodine in Croup. By G. S. C. Har- 
per, M. D., Danville, Mo. 

I have used the tinct. iodine in croup with the happiest 
effects. A little patient of mine, aged six months, and quite 
fleshy, had several severe attacks of croup, which nearly ter- 
minated her existence. I pursued the regular expectorant 
and revulsive course without seeming to eradicate the dis- 
ease ; to be sure, relief was obtained, but the first exposure 
brought about a recurrence of the disease. I then determin- 
ed, after due consideration of the pathology of the case, and 
the properties of iodine, to use the latter topically, in the 
form of tinct., should the next attack be violent. The next 
attack presented a more formidable appearance than either 
of the preceding. Her system had become debilitated from 
the free administration of nauseants and mild purgatives^ 



GUN COTTON IN ERYSIPELAS. 219 

while the hacking cough and tracheal rattling were no less 
distressing than before. In consequence of her debility, I 
determined to change the expectorant (compound syrup of 
squills) and substitute a syrup prepared by slicing an onion 
and laying it, a slice at a time, in a saucer, covering each 
slice with a layer of brown sugar of about the same thick- 
ness. The exuding juice of the onion* melted the sugar, 
and formed with it a most beautiful and rich looking syrup, 
of which I gave a teaspoonful every few minutes during the 
fit of coughing, as a stimulating expectorant, painted the 
trachea with a strong tinct. iodine from the sternum to 
Adam's apple, and extending it on each side as far out as 
the margin of the sterno-cleido-mastoideus. Nothing more 
was administered, save a little leum ricini, to move the 
bowels gently, and a repetition of the syrup when the cough 
required it, i. e., when it was dry and ineffectual. The 
child recovered without further trouble. Two months have 
now elapsed since there has been any tracheal affection 
whatever, and I am inclined to believe the disease entirely 
eradicated, as there have been frequent changes and much 
damp weather since that time. — St. Louis Med. Journal. 



On the use of the Ethereal Solution of Gun Cotton as an 
external applicatin in Erysipelas. By J. W. Freer, M. D. 
of the Grove, Cook Co., 111. 

Having made use of the adhesive liquid plaster as an ex- 
ternal application in erysipelas, with the most gratifying 
success, I thought it not improper to make known the results. 

An epidemic of the above named disease prevailed in our 
vicinity last spring, and annoyed me not a little to find ex- 
ternal remedies to alleviate the smarting, burning pain of the 
inflammation, and to prevent it from spreading over the sur- 
face. Reasoning from the fact that such inflammations are 
usually superficial, involving principally the capillary sys- 
tem of the cuticle and subcutaneous tissues, it seemed rea- 
sonable to suppose that any substance which would, after 
application, contract, thereby expelling the superabundance 
of blood from the part, of course lessen the pain and irritation. 
After experimenting, my anticipations were fully realized. 

The first trial was upon a boy about 10 years of age. The 

*The onion loses its expectorant property in a very great degree by being ex- 
posed to a very high temperature. 



220 COD LIVER OIL. 

inflammation commenced at the nose, and continued to tra- 
vel until it had involved the whole of the face, scalp, neck, 
and finally passed down the back, ultimately uniting in front. 
The pain and irritation resulting from the inflammation, 
added to the constitutional symptoms, made the case appear 
quite hopeless. At this period the solution was applied by 
means of a feather over the whole of the recently involved 
surface, and immediate relief was given. The inflammato- 
ry redness disappeared, and a firm coating was given which 
entirely protected the parts from the air, and the contact of 
clothing. The patient soon began to recover rapidly. 

Afterwards I tried it in many instances with like success, 
with this addition, that no case afterwards traveled beyond 
its limits at the time of application. I do not presume to say , 
that the spreading was prevented by it, for the inflamma- 
tion might not have gone beyond these limits without its 
agency. Since then I have had occasion to use it in other 
affections, the most important of which are burns. It forms 
a firm coating, excluding the air, and almost instantaneously 
relieving the pain. In common inflammation, from what- 
ever cause arising, its application seems to promote a termi- 
nation by resolution, acting upon the same principle as in 
erysipelas, that is by squeezing, as it contracts the fluids 
from the parts, thereby reducing the morbid action. — Ohio 
Medical and Surgical Journal. 



The Modus Operandi of the Cod Liver Oil. By C. W. 
Wright, M. D., of Cincinnati. 

The remarkable results lately obtained by the use of the 
cod liver oil in the cure of sturmous affections, and in fact 
almost all cachectic diseases, has attracted a great deal of 
attention from the members of the medical profession. 

In the cure of the various forms of cachectic diseases, 
which are the result of scrofulous diathesis, either heredita- 
ry or acquired, it is found that no single remedy has such a 
decided tendency to arrest and prevent the various forms of 
cacoplastic and aplastic depositions. In the deposit of tuber- 
cular matter in the lungs, in the mesenteric glands, in the 
lymphatics of the neck, or in any other part of the body, no 
remedy is equal to this. In fact, we can calculate with al- 
most as much certainty on the removal of tubercular matter 
from the cervical glands by the employment of this remedy, 



COD LIVER OIL. 221 

as upon the cure of an intermittent by the administration of 
quinine. But the employment of this agent is not confined 
to the cure of tuberculosis, for it is found to exert a benefi- 
cial influence in cases of malignant, and other morbid 
growths, by retarding their developments and bringing about 
a more healthy condition of the fluids of the body. 

The cod liver oil has been long employed on the conti- 
nent of Europe in the cure of rheumatism and other kin- 
dred diseases, but its beneficial influence in these and other 
maladies has not been fully recognized in this country until 
a comparatively recent period. But of late it has been ad- 
ministered not only in rheumatism, but in syphilitic affec- 
tions of bones and their periosteum, with the most flattering 
reaults. 

Chronic ulcers, accompanied with a free discharge of pur- 
ulent matter, occurring in old persons, are acknowledged 
by all surgeons to be very difficult to cure, and frequently 
to resist all the ordinary methods of medication had recourse 
to in such cases ; and if, by any means, the discharge is sud- 
denly arrested, to be followed by most alarming, if not fatal 
symptoms. Now in cases of this kind, by the proper admin- 
istration of the cod liver oil, in conjunction with a well di- 
rected course of hygienic treatment, the cachectic state of the 
system rapidly gives way, and is succeeded by a speedy 
healing up of the ulcers and a restoration to perfect health. 
Several such cases have lately fallen under my notice, and 
one in particular which deserves a more especial considera- 
tion. It occurred in the person of a gentleman aged about 
forty, who had been under the treatment of some of the 
most eminent physicians of this city for a long period of 
time, they having pursued the ordinary course of manage- 
ment taken in such cases, without any benefit resulting. But 
upon putting the patient on the use of the cod liver oil, in 
conjunction with small doses of the syrup of the iodide of 
iron, there was a rapid improvement in all the functions of 
the body, followed in the short space of three weeks by an, 
entire recovery; there having been all this time no local ap- 
plications except the simple dressing. ■ 

This remedy produces very decided improvement in cases 
of syphilitic eruptions and ulcerations, attended with the for- 
mation of purulent matter. In all these cases much good 
results from the use of some preparation of iodine, in con- 
junction with the cod liver oil. 

Now what is the modus operandi of this remarkable me- 



222 COD LIVER OIL, 

dicine ? Why is it that the oil of the cod's liver is prefera- 
ble to the other fixed oils ? Why is it that it is more effica- 
cious when given in conjunction with some preparation of 
iodine ? Why is it that the iodides of iron and potassium 
should not be given indiscriminately with that medicine ? 

Before we attempt a solution of the above, let us exam- 
ine the chemical composition of tubercle. An ultimate 
analysis of crude pulmonary tubercles, by Scherer, yielded : 

Carbon, .... 53.888 

Hydrogen, . . . . 7.112 

Nitrogen, . . . . 17.237 

Oxygen, .... 21.767 

Which corresponds with the formula C. H. N. 0. 

43 35 6 14 

Hence, tubercles may be regarded as proteine, from which 
atoms of carbon, one of hydrogen, and one of oxygen have 
been removed.* 

As the proteine series of animals are derived from the 
vegetable kingdom, there is no other way of accounting for 
their losing some of their elements, as in the case of tuber- 
cle, than by refering it to oxidation. For in cachectic dis- 
eases the proteine compounds are particularly prone to suf- 
fer oxidation ; whilst the hydro-carbon of the blood and tis- 
sues is not consumed as in health. 

The proteine bodies certainly undergo oxidation in rheu- 
matism, and gout, which is the result of syphilis. It is well 
known that suppuration is purely a process of oxidation. 
Knowing these facts, I think it would not be difficult to ex- 
plain the modus operandi of the cod liver oil in the cure of 
this class of diseases. 

It is observed in all diseases, where this remedy is of ser- 
vice, that the proteine series are oxidated in preference to 
the fatty matters. But by the introduction of this oil into 
the system this state of things is put a stop to, as is observed 
in phthisis pulmonalis, for under the use of the cod liver oil 
the inflammatory crust does not manifest itself when the pa- 
tient is bled. And by its use scrofulous ulcers cease to sup- 
purate, and are soon healed, the patient rapidly regaining 
his health. 

In chronic rheumatism this medicine succeeds best when 
given in connection with the iodide of potassium. The rea- 
son of this appears to be due to the fact that the potassium 

* Dr. Day. 



MORTALITY OF MALE CHILDREN. 223 

unites with the lithic acid, after having been oxidized, form- 
ing the lithate of potassa, which is excreted by the kidneys. 
But when it is administered for the cure of scrofulous dis- 
eases, it should be combined with the iodide of iron, tonics 
being more especially indicated in these cases. 

As to the cause of the cod liver oil being more efficacious 
than other fixed oils, this appears to be due to two reasons. 
First, that the fish oils do not disorder the digestive organs 
as much as other oils ; and secondly, to the fact that this oil 
contains iodine and bromine as constituents. But 1 do not 
by any means assert that its efficacy depends solely on the 
presence of these chloroid elements. I do contend, how- 
ever, that the cod liver oil would not succeed better than 
any other fixed oil, as a remedy in scrofula, if iodine and 
bromine did not make a part of its constitution. 

The whole of the matter appears to be this : that in the 
affections in which this medicine succeeds in effecting a cure, 
the oxygen which enters the circulation, instead of combi- 
ning with the hydro-carbon, unites with the carbon of some 
one of the proteine compounds and removes it as in the case 
of pulmonary tubercle, or it may unite with the proteine 
itself and convert it into the binoxide and tritoxide of pro- 
teine, constituting suppuration and ulceration, or it may con- 
vert the proteine bodies into urea and lithic acid, as occurs 
in rheumatism. 

The cod liver oil arrests all these transformations by com- 
bining with the oxygen, and in that way prevents the oxi- 
dation of the proteine series. The iodine assists in this 
change, by promoting the oxidation of the fatty matters, in- 
stead of the proteine, for the chloroid salts cause a rapid oxi- 
dation of the adipous tissues. 

This, then, appears to be the manner in which the cod 
liver oil operates. And it will probably be found that the 
other fixed oils will succeed equally well in the cure of this 
class of diseases, when given in conjunction with a chloroid 
salt. — Western Lancet. 



Upon the causes of the greater mortality of male children, 
and the influence operating to change the relative pro- 
portion of the sexes at birth. By G. Emerson, M. D. 

"Cp to the fifteenth year, there is an excess of fifteen per 
cent, in the number of boys over that of girls. This excess 
in the male mortality is commonly ascribed to the greater 



224 MORTALITY OF MALE CHILDREN. 

exposure, and rougher sports and amusements of the boys ; 
an erroneous idea, the fallacy of which is shown in the fact 
that the majority of the deaths of the males takes place in 
early infancy, when no such exposure and danger conse- 
quent to said rough sports can possibly exist. The deaths 
of -boys, too, from climbing, swimming, &c., equal those of 
the girls from scalding, domestic accidents, &c, 

The particular diseases which give rise to death in the 
two sexes, are very different in their nature and character- 
istics. Thus, males are attacked with violent inflammation 
of the brain, accompanied with serous effusions, convul- 
sions, &c; inflammations of the stomach, lungs, and other 
important organs ; while females suffer from the hooping- 
cough, small-pox, measles, thrush, &c. In boys, the char- 
acter of the disease is sthenic ; in girls, asthenic. The dis- 
eases from which females suffer most are seated in the cuta- 
neous and mucuous tissues. 

Of 100,000 deaths reported by the Registrar-general of 
England, 31,671 were under the fifth year; and of these, 
15,006 were females, and 16,665 were males. Of the above, 
the number of deaths from inflammation of the brain were 
2550 males, and 2081 females; of dropsy of the brain, 1481 
males, 1151 females; small pox, 313 males, 240 females; 
hooping-cough, 1115 males, 1445 females; measles, 1048 
males, 1028 females, etc. 

From these and similar statistics, the inference follows 
that the disproportion in the deaths of the two sexes, during 
childhood, does not arise so much from exposure to external 
circumstances, as from differences in physical organisation. 

From the fact of boys succumbing so easily and so rapidly 
to diseases of a sthenic type, and females to those of an as- 
thenic character, we deduce the practical hint of combatting 
most energetically the inflammatory symptoms, of the one, 
as soon as manifest, and preventing too great exhaustion of 
the system when symptoms of depression begin to appear 
in the female infants. 

The Dr. then spoke of the effects of weather upon infant 
mortality, and more particularly of the limitation of the ef- 
fects of hot weather, to the period of lactation. For inter- 
esting facts relative to this subject, he referred to statistics 
lately published by himself in the Medical Journal of the 
Medical Sciences. 

During the first year of infant life, the season of the great- 
est mortality is the three hot summer months. The number 



MORTALITY OF MALE CHILDREN. 225 

250 representing the mortality for May, we would have 836 
as that for July. After the second year the deaths are more 
equally distributed throughout the months; the number 
seeming even less in the hot than in the temperate and cold 
seasons. The heat, which at an earlier period was inimi- 
cal, would now appear to be friendly to infantile life. 

Dr. E. next referred to the influence of certain agencies 
which changed the ordinary proportions of the sexes. The 
general preponderance of males over females at birth, is 
about lh per cent. In 1833 the singular phenomenon of a 
reverse proportion was evident. There was not only a de- 
ficiency of male births, but moreover, in the months of April 
and May of that year, a decided female excess. Upon fur- 
ther investigations, this female excess was found to be the 
product of conceptions occurring in the months of August 
and September of 1832. This, as is well known, was the 
period of the first invasion of the epidemic cholera. Look- 
ing abroad for corroboration of this singular fact, it was 
found to hold good also, in the proportion of births occurring 
nine months after the epidemic had appeared in Paris. From 
this and other investigations, he arrived at the conclusion, 
that this change in the relative proportion of the two sexes 
at birth, was owing to the depressing influence of cholera. 
He has further observed that a tendency to the above result 
is always produced by the operation of any class of depress- 
ing agents, while circumstances that tend to high physical 
developement increase materially the male excess. 

In France and Prussia, where the mass of the people labor 
much harder than in our own country, and are poorly cloth- 
ed and fed, the excess of female births is slightly under 6 
per cent.; in England, 5 per cent.; in Philadelphia, 7.5 per 
cent.; and in our western country as high as 10 per cent. 

Investigations into the comparative proportions of the 
sexes born in city and country populations, manifest the ex- 
istence of a greater male excess in rural districts. This, from 
the foregoing observations, was to be expected, since in ci- 
ties, intemperance, foul and vitiated atmosphere, unwhole- 
some diet, and other depressing agencies, operate much more 
strongly than in the country. Hence, the Dr. observed, this 
proportion of the births of the two sexes, maybe considered 
as a sort of natural thermometer of the physical comfort and 
advantages enjoyed by a community. 

The institution of polygamy may have originated in a 
scanty supply of food occurring at some former period in the 
29 



226 TREATMENT OF DYSENTERY. 

community where such institution exists, and evincing hs 
depressing tendency by a predominance of the female over 
the male population. Once established, it would foster 
itself. 

The proportion of the two sexes being under such con- 
siderable control, it remains for the various legislative bo- 
dies throughout the civilized world to benefit and meliorate 
by their wise enactments the condition of the social cosmos. 
— Philadelphia Medical Examiner. 



Treatment of Dysentery by injection of Nitrate of Silver 
and Creosote. By Professor Flint. 

The nitrate of silver, as we know, in analogous instances 
of inflamed mucous tissues — for example, in conjunctivitis, 
pharyngitis, &c, exerts a surprising effect in diminishing 
and arresting inflammatory action. It has been employed, 
to some extent, in dysentery, and is recommended by some 
practical writers ; but so far as we know, is by no means in 
common use. In one case we resorted to a solution of the 
crystals of the nitrate of silver, ten grains to the ounce, with 
marked benefit. The tenesmus and frequent dejections 
were relieved in a striking degree, and the discharge of mu- 
cus and blood was much diminished. To secure the good 
effects of this application, it is desirable that the injection be 
made to pass up the intestine as high as practicable, in order 
to bring it into contact with a large portion of inflamed sur- 
face. We found the best instrument at hand to be a female 
bone syringe, with a long pipe, terminating by a perforated 
bulbous extremity. Perhaps a solution of greater strength 
might be even more serviceable. The patient was a child 
four years of age. The application occasioned, apparently, 
little or no pain ; not more than the ordinary enemas of 
starch and laudanum. Another remedy employed in the 
same case was a creosote mixture. We have used this re- 
medy in two cases ; in one, of chronic dysentery of long 
standing, the effect was good, but not extraordinary. In 
the case recently under treatment, we first employed it in 
connexion with the tincture of opium, and found that the 
enemas were retained, when with the laudanum alone they 
were immediately expelled. We employed at first a mix- 
ture for each injection (oz. ss.) containing two minims of 
creosote. Subsequently we employed the creosote alone. 



NEURALGIA AND RHEUMATISM. 227 

increasing the quantity to four minims, and the good effects 
were striking. The relief of the local symptoms was quite 
as great as when the opium was given in combination, the 
disadvantages of the latter being avoided. We feel confi- 
dent that this will prove a valuable remedy in dysentery, 
and we therefore are solicitous that our readers should 
make trial of it. We do not, of course, suggest these as re- 
medies intended to supersede other therapeutical measures, 
but only as useful auxiliaries thereto. — Buffalo Medical 
Journal. 



Neuralgia and Rheumatism treated by cold draughts af- 
ter sweating. 

At Bellevue, near Paris, there is a fine establishment, in 
which everything of practical value connected with " the 
water-cure" — be it hot or cold — is applied to the treatment 
of various obstinate affections. The advantages obtained 
from a rational employment of several powerful agents, as 
distinguished from the empirical use of one alone, are very 
great. They were pointed out in an excellent Memoir 
which Mr. Fleury presented at the last meeting of the Aca- 
demy of Sciences. The author selected forty-six cases, ob- 
served at the establishment during the last four years, and 
from their results deduced the following conclusions : 

Five patients, laboring under attacks of acute neuralgia 
from four to fifteen days, (facial, intercostal, sciatic,) were 
cured by one to three applications of the cold douche, both 
general and local, employed after the use of the dry stove, 
which had produced copious transpiration. Here the revul- 
sive action of heat followed by cold was much more ener- 
getic than that of flying blisters, or the cautery. 

Eleven patients, attacked by acute muscular rheumatism, 
fixed in its seat and very severe, were rapidly cured in the 
same manner. 

In four cases of obstinate neuralgia, which had resisted 
every known method of treatment for four to ten years, a 
cure was obtained by cold douches (general and local,) 
sometimes preceded by the use of the hot-air bath. The 
duration of the treatment varied from one to six months, 
and its average was three months. Three patients, who for 
five to fifteen years had presented, in the most marked de- 
gree that ensemble of symptoms known under the title of 



228 TREATMENT OP HYSTERICAL FITS. 

"nervous accidents," and who had been reduced by them 
to the lowest state, in spite of medical art, were cured in the 
same manner. Here, however, the treatment was continued 
from seven to eighteen months, and the average duration 
was more than a year. 

Finally, in twenty-three cases of chronic muscular rheu- 
matism, which had resisted every species of treatment, and 
the most celebrated mineral waters of Europe, the cold 
douches after sweating effected complete cures. The aver- 
age time of treatment was four months ; the minimum one 
month ; the maximum seven. 

Here, it must be confessed, we have a rational method of 
treatment, applied according to the rules of art, and as suc- 
cessful as the miracles of Hydropathy. — Lond. Med. Times. 



Effects of the Moral Treatment of Hysterical Fits. 

A young lady, who had met with a very severe disap- 
pointment, was placed under our care. She was 23 years 
of age, and hereditarily predisposed to the disease on both 
sides. It manifested itself by an excited state of mind, with 
startings and restlessness, and she had frequent hysterical 
fits. Every attention had been paid to her health before she 
quitted home, but having attempted to throw herself out of 
the window, it was deemed proper to remove her from the 
scene of her excitement. She was cheerful and clever, and 
very susceptible of admiration. When she first came, she 
stated that her fits were so frequent that it was not right for 
her to go to church; but as they were really not violent, we 
observed to her that it was always the rule of the house to 
go to church, and that if the fit came on there, we should be 
obliged to call for the assistance of the beadle to take her 
out ; and that she would thus make herself very conspicu- 
ous. After the service of the first Sunday, she observed, 
on coming home from church, that she was very nearly at- 
tacked indeed ; and it was remarkable that she never had 
any fit at these times afterwards. We took courage from 
this, and hoped the time would come when the fits would 
disappear, not only at church, but altogether, by a similar 
mode of treatment. One day, while at dinner, her knife and 
fork dropped suddenly into her plate, and she was simulta- 
neously upon the floor. There were several at the table, 
and the servant was requested to give no heed to the lady. 



EPIDEMIC TYPHOID FEVER. 229 

After a few minutes had passed away, a gentleman who 
was at the table, whose pharmaceutical knowledge would 
never make his fortune, feeling a little nervous about the 
issue of the case, rather anxiously suggested that she should 
have some Epsom salts — meaning, no doubt, to say smell- 
ing salts, given to her. This was quite enough. She laugh- 
ed very much, and resumed her place at the table, and all 
went on as before. And it is very pleasing to be able to 
add, that for the few months longer she remained with us 
she experienced no return of the fits either at church or at 
home ; her irritability and oddness of manner went off, and 
she continued well. This is now eighteen years ago, and 
there has been no actual return of the threatened malady, 
though she has been extremely nervous at times, many sor- 
rows and trials having attended her. If these fits had been 
neglected or encouraged by bad management at the first, 
the probability is, she would, with all the predisposing cir- 
cumstances of the case, have been the subject of insanity at 
the present time. — Dr. Burnett on Insanity. 



Observations upon Epidemic Typhoid Fever, which pre- 
vailed along the Valleys of the Oswayo and Honey oye 
Creeks, in the Counties of McKean and Potter, Pa., 
during the Summer and Winter of 1847; and upon 
the use of Calcined Mercury in its early treatment. 
By R. P. Stevens, M. D. 

I remark that this fever was preceded in every neighbor- 
hood, in each family, and in every instance, by an epidemic 
influenza. The character of this influenza was, upon the 
whole, mild, although in three cases it induced consumption 
in persons predisposed to phthisis, which ended fatally, and 
in several others acute bronchitis, which, however, easily 
yielded to appropriate treatment. 

The symptoms of this influenza, as felt by myself, were 
as follows : A sudden invasion, violent sneezing, as if some 
insect was irritating the schneiderian membrane, and not 
only irritating, but also stinging it. I presume I sneezed at 
least a hundred times in a ride of as many rods. In a few 
hours an irritating cough followed, with some oppression of 
the chest, deep-seated pains, with soreness of the flesh; chills, 
with flashes of heat rapidly succeeding each other ; dryness 
of the skin. A remarkable feature, always attending, and 



2 30 EPIDEMIC TYPHOID FEVER. 

generally supervening the third day from the attack, was 
salivation and folliculitis of the mouth and fauces. In some 
cases this ptyalism was so severe as to lead the patients to 
suppose that they were affected with calomel. Severe con- 
stipation of the bowels attended, though in some cases diar- 
rhoea was present. I prescribed for some one hundred cases, 
and there were many more so mild as to need only house- 
hold remedies. This influenza preceded the fever some six 
weeks, yet in some cases they were nearly blended, the pa- 
tient only convalescent from the first, before being attacked 
by the fever, the one apparently running into the other. 

The general features of the fever were in the graver cases 
sudden prostration of the strength, with chills, speedily fol- 
lowed by fever, a tensive pain in the head, ringing in the 
ears, deafness, oppression of the stomach, eyes suffused, face 
red, skin dry, pulse 100 to 120, and reluctant and vascilla- 
ting; a general tremor, with difficulty in commanding the 
movement of the muscles, the patient appearing as if over- 
come with alcohol ; the tongue trembling and forgetting to ar- 
ticulate more than half a sentence ; coated with a slimy yel- 
low coat in the middle, and successively changing to a light 
brown, dark brown, and lastly black ; the tip and edges red, 
and soon assuming a glazed appearance ; in the progress of 
the disease becoming cracked and sore ; teeth covered with 
sordes ; intense thirst, great heat of the skin, especially of 
the belly ; the pulsation of the abdominal aorta felt its whole 
length ; bowels costive ; somnia with delirium attended. 

These symptoms are taken from a case which had no me- 
dical treatment whatever, and which, therefore, offered itself 
as the true type of the disease. 

Treatment. — And here it is I wish to speak of the great 
and certain powers of the calcined mercury, in breaking up 
and overcoming the morbid impression made upon the sys- 
tem by this fever in its earlier stages ; and I might remark 
parenthetically, not only in this, but also others, especially 
those of a congestive type, in every case where the tongue 
had a yellowish coat, a full emetic of this mineral was ex- 
hibited, sometimes aided by ipecac, where I wished a pro- 
longed emesis. The ejections of the stomach were uniform- 
ly thick, viscid mucus, with bile After the emetic a full 
dose of pulv: Dov: was administered with infus: eupatorium 
perfol: .; epithems to the bowels. The day following, if feb- 
rile symptoms had at all remitted, Dover's powder, with qui- 
nine or sulph: cupri, with sulph: morphia and ipecac, were 



EPIDEMIC TYPHOID FEVER. 231 

exhibited. This course of medication cured two cases in 
two days, ten in three, one in four, five in five, and four in 
seven. If, however, on the day following the emesis, the 
fever continued unabated, alteratives were prescribed until 
the dejections of the liver and bowels showed the influence 
of mercury. For this purpose hyd : cum creta, with ipecac, 
was preferred. Epispastics to the abdomen, and if great, 
somnia also to the nape of the neck, and in one case behind 
the ears. Carb: amm: and infus: serpentaria were freely ex- 
hibited. When the fever continued beyond the fourteenth 
clay, carb: amm: with wine and sulph: quinine were largely 
prescribed. Rubefacients to the extremities, wrapping them 
up in cotton batting, having first bathed the cuticle with 
oleum monardgs. Three cases ran fourteen days, two twen- 
ty-one days, and one proved fatal the fifteenth day. 

A peculiar characteristic of the fever was a tendency to a 
discharge of blood on critical days. If we take the case 
which serves as the type of the disease, we find it running 
fourteen days without treatment, most of the time sleeping, 
huddled up in the bed-clothes,sliding down to the foot-board, 
and finally having a violent hemorrhage from the nose, 
mouth and rectum. Five had hemorrhage from the rectum 
alone ; three from the nose; one from the stomach; one 
rather mild case, treated only with infus: eupatorium perfol: 
had an alarming hemorrhage from the nose ; one from the 
uterus, and another complicated with abortion in a woman 
accustomed to miscarriages. 

To restrain the sanguineous discharges, ethereal ext: tan- 
nin was used with decided effect. 

Where the fever assumed the nervous or sinking form, an 
infus: serpentaria, Colombo and valerian, in equal quantities, 
proved a valuable combination. 

In two cases, where it assumed a periodical character, 
quinine in full doses promptly arrested it. 

In one case, a patient aged fourteen years, subject to fre- 
quent attacks of epilepsia from infancy, opisthotonos ap- 
peared the third day, and proved fatal the seventh. In this 
case opium, with its alkaloids, exts: belladonna, stramonium 
and aconite, with wine and quinine, epipastics to the spine, 
were used in heroic doses without any mitigation of the 
symptoms, opium only excepted : this would give some sleep, 
some brief forgetfulness of his terrible agonies. Great tenes- 
mus and dysuria attended. 

The calcined mercury which I use, is manufactured by Mr. 



232 CASE OP TETANUS. 

Richards, an apothecary at Jordan, Onondaga Co., N. Y.,by 
a process somewhat different from the formula of the U. S. 
Dispensatory, which renders its action more mild and equa- 
ble than is described in that work. It is a fine, impalpable 
powder, of a yellowish rather than reddish aspect. In doses 
of one or one and a half grs:, it is a prompt emetic. In these 
doses I prescribe it. — N. Y. Journal of Medicine. 



Peculiar Case of Tetanus, occurring twelve days after 
the operation of " Excision of a Scirrous Mamma" 
By Samuel Tyler, M. D. 

Mrs. P , aged seventy years, a very intelligent lady of 

Virginia, the mother of a numerous family, many of whom 
have been and still are distinguished in the various profes- 
sions and callings of life, visited Frederick on the 13th day 
of December, 1849, for the purpose of having a scirrous tu- 
mor of the right mamma removed. 

She stated that the tumor in the breast had appeared spon- 
taneously; and when first noticed four years ago, was the size 
of a small walnut, and had gradually been increasing until 
it reached its present size, which was about that of a large 
orange. Near the right side of the nipple there was some 
little excoriation, produced by its having been lanced, and 
using external applications, previous to her visit to Frederick. 

She was advised by my father — an old and experienced 
physician — and by myself, to the following effect: That as 
there was excoriation of a portion of the skin, it was highly 
probable there was constitutional contamination, although 
there was no axillary or other swelling, independent of the 
tumor itself; but as that excoriation would certainly be the 
forerunner of deep ulceration,which would produce hemor- 
rhage, lingering suffering, and death ; and moreover as she 
was so far advanced in life, and apparently of so robust and 
healthy a constitution, (her mother having lived to the age 
of eighty-six or more years,) her chances of a prolonged life 
would, in our opinion, be enhanced by the removal of the 
breast.* 

* I think it not amiss to state here, that we were strengthened in this 
opinion, by the result of the following case: I removed a tumor, having 
many of the characteristics of scirrous, (a large fungoid growth protrud- 
ing from an ulcerated portion of the breast, the whole mass weighing near- 
ly eight pounds,) two years since, from the person of a very delicate lady, 
aged about 42. She is now living, and in better health than she has been 
for many years. 



CASE OP TETANUS. 233 

On the morning of the 19th of December, in the presence 
and with the aid of my father and Drs. Stainer and Johnson, 
I removed the tumor with the knife, having previously placed 
the patient under the influence of chloric ether, which saved 
her much suffering, although it did not act so well as in many 
instances in which I had used it before ; attributable, I think, 
to the extreme agitation which came over the patient just 
previous to the operation, having made a great effort to be 
composed for several days before. 

After the operation the wound was dressed in the usual 
way, and the patient placed in bed. Until the period of the 
first dressing, which was prolonged to the 23d, she continued 
in as good a condition as could have possibly been expected, 
excepting some occasional nervous spells, which were al- 
ways relieved by stimulants. On the morning of the 23d 
the wound was opened and dressed. It looked healthy, with 
some little suppuration in the upper portion. During the 
dressing, the patient was considerably affected by the smell 
of the wound, though her spirits were lively and cheerful. 
Stimulant treatment and nutritious diet were continued, and 
a mild aperient to be administered pro re nata. 

25th. — Dressed the wound. There was very free lauda- 
ble suppuration all over the surface, with some healthy gran- 
ulations in the upper part. Her condition generally good. 
Same treatment continued. 

The same condition of things in reference to wound and 
patient continued until the evening of the 1st of January, 
when she complained of stiffness in the back of the neck, 
which was attributed to the position of her head in the bed. 
This was changed, and an opiate administered. 

Jan. 2d, 9 A. M. — There was a slight degree of trismus, 
so slight though, as to lead us to hope it was mere appre- 
hension. At this juncture, and not until then, were we in- 
formed that the patient had had for years a continual horror 
and fear of dying with tetanus. The wound, which still 
looked healthy, discharging laudable pus, was dressed, 
chloric ether being administered at the time. Ordered pills 
of camphor and opium every four hours, with occasional in- 
halations of ether in the intervals. This treatment at times 
seemed, and undoubtedly was beneficial, and we indulged 
the hope of her recovery. Some of her symptoms resem- 
bled those of the case not long since reported by Prof. Jack- 
son, of Philadelphia, (see Am. Jour. Med. Science, April, 
page 298,) such as being greatly agitated, and sometimes 
SO 



234 CASE OF TETANUS. 

spasms being produced by the least tread of a slippered foot, 
or the rustling of a dress. She had, however, no fear or 
dread of water. The exhibition of opiates, especially a cam- 
phorated tincture of opium, occasionally relieved the fixed- 
ness of her jaws, as if it were a charm, but the beneficial ef- 
fects were never lasting in their nature. 

Without going further into the minutise of the case, suffice 
it to say, that the tetanic symptoms increased violently, and 
baffled all treatment, until death closed the scene of this sad 
case, on the morning of the 8th of January, in the form of 
ataxia and adynamia. Her mind was nearly always clear. 
It should be recollected that, as was before mentioned, from 
the moment the first symptom of this dread disease appear- 
ed, and it could scarcely be called a symptom of tetanus, 
the patient gave herself up to the apprehension or imagined 
certainty of death. What in my opinion is a great peculiar- 
ity in the case, besides her age, tetanus rarely ever occur- 
ring after the fiftieth year, is the fact that the wound con- 
tinued discharging healthy pus, and was covered with fine 
healthy granulations, up to the very moment of dissolution, 
and in every way presenting the most favorable appearance. 
I will also state there was but one artery ligature, and it 
very small. The wound had also cicatrized greatly, one 
half being closed at the time of death. These facts certain- 
ly are not in accordance with the experience of the profes- 
sion, in reference to traumatic tetanus. Then, was this dis- 
ease produced by apprehension, is a query, which I think 
this case justifies being put to the profession. It may serve 
to excite interest with reference to this most interesting dis- 
ease, and probably tend to its elucidation. The neuro-dy- 
namic force of the system has nothing of a settled nature, 
and hence its irregularities must tend to making our know- 
ledge of it more uncertain. In tetanus, nervous ataxia ex- 
hibits its culminating points ; if we can only understand this 
completely, we have made considerable progress towards a 
full knowledge of the laws governing the nervous system. 

I would add in conclusion, that I can find on record no 
case of tetanus occurring after removal of the breast, but 
one, which occurred some years ago in St. Bartholomew's 
Hospital, and its history is not given.— N. Y. Med. Journal* 



CHLOROFORM IN CHOLERA. 235 

On the use of Chloroform in the Collapse of Cholera. By 
P. C. Van Wyck, M. D. 

Being employed in the late epidemic as one of the physi- 
cians to the Blackwell's Island Hospital, I had an opportu- 
nity of seeing a great deal of this fatal disease, and had the 
satisfaction of trying the different modes of practice, as re- 
commended by the most eminent writers on the subject. So 
far as the first stages were concerned, about equal success 
attended each method ; and, generally speaking, there were 
about as many patients cured in that hospital, in proportion 
to the number treated, as in any other institution of a simi- 
lar character. Of the collapse cases, the mortality was fear- 
fully Jarge, some however recovered. But as in similar 
cases elsewhere, all treatment seemed to be of little avail in 
arresting the fatal progress of the disease. On the 6th of 
August, however, as the epidemic was about taking its 
leave, the first case occurred in which the cure could be sa- 
tisfactorily attributed to the means employed ; it was as fol- 
lows : — 

Case 1. — Emma Marshall was attacked with vomiting 
and purging, on the 6th of August, 1849 — of good constitu- 
tion, age 22 years — had been admitted into the hospital with 
syphilitic buboes, which were suppurating ; she had had a 
slight diarrhoea for a few days previous. At the time of the 
attack two camphor and opium pills were ordered to be giv- 
en after every stool, and the patient to be kept in bed. 
About two hours aftewards saw the patient, and found she 
had been unable to keep the pills on her stomach ; the pills 
were then stopped, and the calomel and morphine powders 
substituted (three grains of calomel, half a grain of mor- 
phine), to be given immediately after vomitting, and enemas 
of laudanum and tannin after stool. About four hours af- 
terwards, visited the patient ; she was no better, and had 
vomitted the powders in the same manner as she had pre- 
viously the pills, — the discharges from her bowels were no 
less frequent, — -medicines both of an acid and alkaline na- 
ture were then resorted to, in order to check the vomiting, 
but with no avail. The patient was well covered with 
blankets, had hot bricks kept to her feet, and sinapisms over 
the stomach, and during the whole time was allowed free 
use of ice. Such was the method of treatment pursued, but 
seemed (as was often witnessed in similar cases) not to have 
the slightest beneficial effect. At seven P. M. saw the pa- 



236 CHLOROFORM IN CHOLERA. 

■ 

tient again, with some of my colleagues ; vomiting and 
purging continued — her extremities were cold, eyes sunken 
and glassy, — cold [perspiration on the surface of the skin, 
tongue cold, — breath cold, face of a leaden hue; pulseless 
at the wrist ; extremities contracted and shrivelled ; every 
three or four minutes seized with violent cramps, and cry- 
ing out at the topmost of her voice, and in fact, every other 
symptom denoting a perfect state of collapse was present. 
Little, if any hopes were entertained of her recovery, and 
as all previous attempts to exhibit medicines by the mouth 
or anus had failed, from the fact that they were no sooner 
taken than they were rejected or discharged, it was decided 
to try the effects of chloroform through the medium of the 
lungs, indulging a hope that so long as the patient was un- 
der its influence, it might arrest the vomiting and purging, 
and also render her insensible to the cramps. I had given 
it before, with camphor dissolved in it, but with no great 
advantage, since it was then liable to the very same objec- 
tion as any other medicine introduced into the stomach, viz. 
it could be vomited ; such were the reasons for trying the 
chloroform. Accordingly, at 8 o'clock, together with Dr. 
MacNeil, I visited the patient again. During my absence 
the powers of life had diminished materially. Whilst the 
Doctor held her wrist I administered the chloroform. The 
patient was kept under its influence for at least ten minutes; 
during that time she neither vomited nor purged, nor did 
she cry out with the cramps ; on taking away the handker- 
chief, however, she soon awakened, and in about five min- 
utes vomited and purged again, and also complained of the 
cramps. ! Alt hough there was no permanent advantage 
gained, still, while she was under the effects of the chloro- 
form she was, to say the least, no worse. The chloroform 
was again given her, and she was kept partially under its 
influence, between sleeping and waking for some length of 
time. In about ten minutes from the second time it was 
administered, the pulse could be perceptibly felt at the wrist, 
and pretty soon the leaden hue of the face disappeared, and 
gave place to a faint blush on her cheeks ; during that time 
she neither vomited or purged, and did not appear to suffer 
at all with cramps. The chloroform acted as a diffusible sti- 
mulant, and by establishing a capillary circulation through- 
out the extremities, appeared to remove for a time the cause 
of the cramps. Being much pleased with its exhibition, and 
fortunately having a very reliable nurse in the ward, I de- 



CHLOROFORM IN CHOLERA. 237 

termined, if possible, to keep the patient under its influence 
all night, and thus use it as a narcotic, with the express 
caution, however, not to interfere too much with the respir- 
ation of pure air. From time to time she was allowed to 
waken, draught of ice water were given her, and then she 
was immediately put under the influence of the chloroform 
to prevent vomiting. This artifice succeeded so well, that 
before morning she drank a large quantity, and it being re- 
tained, of course must have been absorbed. On the morn- 
ing of the 7th, called to see the patient; she no longer com- 
plained of the cramps, the discharges from the bowels had 
almost entirely ceased, and the vomiting had stopped, al- 
though her stomach was irritable, and she complained of a 
distress and pain over that region. The chloroform was or- 
dered to be discontinued, and a blister to be applied to the 
epigastric region, and a calomel and morphine powder given 
every hour, to aid, if possible, in relieving the engorgement 
of the liver (the powders, however, were soon discontinued) 
and the patient was not salivated. From the time the vo- 
miting ceased, the stools were less frequent, the wonted co- 
lor returned to her face, and except the pain over the region 
of the stomach, she was quite comfortable. In the evening, 
the blister not having drawn, she was cupped over the part; 
this seemed to give considerable ease. She soon began to 
take stimulating nourishment, and gradually recovered. 

Case 2. — Emma Heard, nurse, 28 years old, had had di- 
arrhoea for three days ; syphilitic patient ; had been salivated 
three times in the course of her life ; was attacked with chol- 
era on the loth of August. I gave her Majendie's solution, 
20 drops every two hours; laudanum and tannin injections 
after every stool, but no calomel ; blankets, warm bricks 
and sinapisms. This treatment, however, seemed to have 
no good effects, and the patient soon passed into the stage 
of collapse. The chloroform was now resorted to, and a 
blister over the epigastrium, together with ice water. Its 
action was precisely similar to that in the first case ; the 
vomiting and purging were arrested, the patient was kept 
asleep and free from cramps ; she was thus carried through 
the critical stage of the disease, but in consequence of the 
severe gastritis which set in, it was some time before she 
finally recovered. But two other cases where marked col- 
lapse set in, occurred during the remainder of the epidemic; 
they were both put under the chloroform treatment ; one 



23S TREATMENT OF SCARLATINA. 

died and the other recovered. The third case, however, 
was complicated with enteritis and dysentery. 

As a remedy in the collapse of cholera, chloroform appears 
to possess the following virtues : 

It is the most perfect of all placeboes^, when the patient is 
kept gently under its influence; diminishes the necessity of 
giving so much opium as may otherwise be given , renders 
the patient insensible to cramps ; checks the vomiting and 
purging so long as its influence is kept up, and being a pre- 
paration from alcohol, has the same diffusible, stimulating 
effects, with the additional advantage, that it can be given 
by the lungs. It seems, however, to be more beneficial in 
those cases in which the patient, passes into a state of col- 
lapse in a short space of time, before much inflammatory 
action has been set up in the alimentary canal, rather than 
iu those where they have done so more slowly, and where 
there is ulceration of the throat and intestines. The tedi- 
ousness and length of time consumed in administering this 
remedy, though a serious objection, if the physician be obli- 
ged to administer it himself, may nevertheless be met by 
giving instructions as to the proper method of using it to 
some reliable person. Further experience must decide the 
question, as to the extent this remedy is valuable in the 
treatment of the collapse of cholera. It is certain, however, 
that chloroform when used in this manner will control vo- 
miting and purging ; since it controls all voluntary muscular 
contraction ; renders the patient insensible to the cramps, 
and will enable the physician to administer as much medi- 
cine, and give as much nourishment, as he may think the 
case demands. — N. Y. Medical Journal. 



Novel Treatment of Scarlatina. 

The London Lancet, published, some months ago, a new 
mode of treating scarlatina, instituted by Dr. Schneeman. 
We copy sufficient of the article to place our readers in pos- 
session of the new therapeutics of scarlatina advanced by 
the author, and we commend it to them as being worth just 
what estimate they may see proper to place on it. The fol- 
lowing are the prominent advantages of this practice, accord- 
ing to the author : — 

1. The possibility of conjoining, with the greatest safety 
to the health and life of the patient, the shortening of the 



TREATMENT OF SCARLATINA. 239 

whole disease, to such an extent, that any patient may'leave 
the house at the expiration of ten days, even during the 
worst weather. 

2. The checking of all infection, by the end of the third 
or fourth day — i. e., with the disappearance of the eruption 
— owing to the formation of the infecting matter, being dis- 
turbed, and thereby the emanation from the skin (the infect- 
ing medium) being prevented. 

Treatment, — The advantages of the treatment now about 
to be laid down, are the annihilation of the injurious effect 
of the exanthem on the functions of the skin. The skin (by 
this treatment) is not, indeed, protected from the eruption, 
but this is so modified that scarcely any desquamation takes 
place ; and the functions of the skin, instead of being dis- 
turbed, and burthening other functions, produce, by their 
continuing in a state of integrity, so beneficial an influence 
on the organs attacked by the malady, particularly those of 
the throat, that the normal condition, is in every case, and 
in every part, speedily restored. In order to realize such 
extensive promises, we must bring into operation the follow- 
ing rules of practice : — 

Applications. — " From the first day of the illness, and as 
soon as we are certain as to its nature, the patient must be 
rubbed every morning and evening, over the whole body, 
with a piece of bacon, in such a manner that, with the ex- 
ception of the face (?) and hairy scalp a covering of fat is 
every where applied. In order to make this rubbing-in 
somewhat easier, it is best to take a piece of bacon, the size 
of the hand, choosing a part still armed with the rind, that 
he may have a firmer grasp. On the soft sides of this piece, 
slits are to be made in various directions, in order to allow 
the oozing out of the fat ; and this is still further promoted 
by placing the bacon, for some time previously to using it, 
near the stove — in the oven, or on the hob. But it is not 
proper to make the friction with a warm piece, and the fat 
must be allowed to cool before using it. 

" The rubbing must be most conscientiously performed, 
and not too quickly, in order that the skin may be regularly 
saturated with fat. During the process, the body is never 
to be wholly uncovered but only that part on which the 
operation is being performed ; and, if considered necessary, 
the whole can be done under the bed-clothes. But such pre- 
caution as this is unnecessary ; the children may safely get 
up. No injury will ever be done by it, and after once see- 



240 CHOLERA AND HOMCEOPATHtf. 

ing it done, the mother or nurse soon learns to relieve the 
medical man of his task. 

" Although this plan, from the mess it makes, is not cal- 
culated to find favor in the world — although it dirties bed 
and linen, as well as the persons of the children — yet the 
first few days of its application produce results which make 
all this forgotten, and inspire the mothers with enthusiasm 
for this method. With a rapidity, bordering on magic, all, 
even the most painful, symptoms of the disease, are allayed; 
quiet, sleep, appetite, and good humor, return, and there 
remains only the impatience to quit the sick-room. To ob- 
tain this, however, other things are necessary besides mere 
infriction with fat, but still I think myself bound to impute 
the most important share of the merit to this peculiar treat- 
ment of the skin.- — Western Lancet. 



Cholera in a New-Born Child. — M. Homolle has report- 
ed an instance in which a woman in labour was attacked 
with cholera. An infant apparently asphyxiated, was born, 
but, after proper remedies, was roused, passed meconium 
and urine, and appeared to be doing well. Twenty-four 
hours after its birth, there came on suddenly serous diarr- 
hoea, vomiting, and all the gravest symptoms of cholera, and 
it died in a few hours. M. Homolle puts the question, whe- 
ther it was infected with cholera in the womb or after birth. 
He inclines to the former opinion. — Medical Times, from 
U Union Medicate, Oct. 23. 



Homoeopathy and the Cholera. — In deference to the as- 
sertions and large claims of the advocates of homoeopathy, 
and in consideration of the comparatively small success ob- 
tained over the mortality of cholera by any method of treat- 
ment, the administration of the Hospitals Salpetriere and St. 
Louis submitted a few cases to the homoeopathic mode of 
practice, but the result did not warrant its continuance. The 
physicians report that all the cases proved fatal. — Ibid, 



Obituary Record. — Died, at Bishopwearmouth, on the 
10th of January, Wm. Reid Clanny, Esq., M. D., F. R. S. 
&c., for upwards of forty-five years Physician to the Bishop= 
wearmouth Infirmary, and inventor of the first safety lamp. 

• at Paris, in the 56th year of his age, Dr. Prus. 



CONTENTS 

OF THE 

NEW JERSEY MEDICAL REPORTER, 

SEVENTH MONTH, (JULY,) 1850. 



TRANSACTIONS OF THE NEW JERSEY MEDICAL SOCIETY. 

Report from Salem County, by Q. Gibbon, M. D. - - 241 

Dr. Elmer's Report, ------ 246 

Abstract of Report from Gloucester County, by 

Joseph F. Garrison, M. D., - - - - 248 
Abstract of Report from Essex and Passaic Counties, by 

Alex. W. Rodgers, M. D., - - - - 258 

Report from the Middle District, by J. J. Dunn, M. D., - - 276 
Summary of Report of Standing Committee, by 

James B. Coleman, M. D., ... 278 

Report on Preliminary Education, by Jos. Fithian, M. D., - 282 
Report of Committee on Charter and By-Laws, by 

S. H.Pennington, M. D., ... - 291 

Minutes of the Eighty-Fourth Annual Meeting, - - 297 

Dr. Taylor's Resolutions, ----- 300 

Officers and Censors, ----- 301 302 

Delegates to the American Medical Association, - - 302 
Licentiates, ....... 302 

ORIGINAL COMMUNICATIONS. 

Autopsy, Revealing Absence of Gall Bladder, by 

D. B. Trimble, M. D., 303 

A Rare Case, by Wm. Challiss, M. D., - - - - 306 

EDITORIAL. 

Clinical Records, ------ 308 

Our Third Volume, ------ 309 

To Correspondents, ----- 309 

New Medical Publications, - - - - - 309 

New Medical College, - - - - - 310 

University of Pennsylvania, ----- 310 

Obituary, --.-.-. 310 

ECLECTIC DEPARTMENT. 

Abstract of Minutes of Third Meeting of American Medical 

Association, held in Cincinnati, May, 1850, - - 311 



THE 

NEW JERSEY MEDICAL REPORTER. 



VOL. III. SEVENTH MONTH, (JULY,) 1850. No. 4. 



TRANSACTIONS OF THE N. J. MEDICAL SOCIETY. 



REPORT OF STANDING COMMITTEE. 

We shall present the Report of the Standing Committee 
to our readers, in detached portions, in consequence of its 
great length. To print it entire, would compel us to omit 
other matter, equally as valuable. We commence with the 

REPORT FROM SALEM COUNTY. 

BY QUINTON GIBBON, M. D. 

Your reporter respectfully submits an imperfect sketch of 
the diseases, which have prevailed during the past year, in 
that part of the Western District, immediately within his ob- 
servation. He finds himself thus restricted, in consequence 
of a misunderstanding on the part of the reporters, for the 
respective district societies, within his jurisdiction, of the 
purport of the resolution passed at the last Annual Meeting 
of the State Society, and which defines their duties. Those 
reporters, believing it to be their duty to report directly to 
you, have not communicated with the reporter for the Dis- 
trict, though solicited to do so. 

The leading features of the diseases, which prevailed dur- 
ing the past year, in that portion of the District under the 
authors cognizance, were undoubtedly impressed upon them 

by the wide-spread epidemic, through which we have so re* 
31 



242 DR. GIBBON'S BEPORT. 

cently passed. Early in the spring of 1849, your reporter 
noticed an unusual tendency to derangement of the biliary 
organs, in most of the diseases which came under his obser- 
vation. This predisposition, at first evidenced by slight di- 
arrhoea, &c, gradually developed itself as the season ad- 
vanced, until it was finally merged into the cholera epidemic. 
This latter assumed the same form, and was characterized by 
the same symptoms as in other sections of the country. The 
epidemic subsided in the autumn, and was succeeded by fe- 
vers of various types, Intermittent, Remittent, Typhoid, &c. 
As these had preceded the Cholera, and heralded its ap- 
proach; so they now followed closely upon its departure. — 
The above mentioned fevers, continued to be the prevailing 
affections, until an unusually late period of the autumn. 

The early part of the winter was remarkably healthy. 

Such other diseases as came under the notice of your re- 
porter, seem also to have worn to a certain degree, the live- 
ry of the epidemic — Rheumatism, Pleurisy, Pneumonia, Cy- 
nanche, Tonsillaris Measles, and Hooping-Cough, were very 
generally accompanied by a coated tongue, and evidences 
of gastric and hepatic irritation, in many instances amount- 
ing to active inflammation. So frequently have these evi- 
dences of gastric and hepatic derangement been observed by 
the author, within a few months past, that he is reminded of 
a similar tendency, which was observed at the same early 
period of the last year. Reasoning from such data, it will 
not perhaps be speculating too much, to express a belief that 
the epidemic of last summer, has not yet expended its force, 
and that it may be even now, reviving its smothered ener- 
gies for a fresh outbreak, during the approaching warm 
weather. 

But perhaps, a separate consideration of the more promi- 
nent diseases, prevalent during the past year, will be more 
in accordance with the object of this report. 

Epidemic Cholera. — This fearful disease, undoubtedly 
constituted the most prominent feature, in the medical histo- 



©R. gibbon's repobt. 243 

ry of the past year. In describing the symptoms and treat- 
ment of the epidemic, as it occurred in this locality, I cannot 
do better than to insert a communication from my friend, 
Dr. Thompson, of this place. He says — " During the latter 
part of the spring, and early in the summer, derangements 
of the digestive organs, sick stomach, diarrhoea, and severe 
attacks of cholera morbus, became of unusually frequent 
occurrence. They were the "avant couriers" which herald- 
ed the approach of the dreaded pestilence. The remark 
which has been made of some epidemics — that during their 
prevalence, they force all other diseases to assume their live- 
ry, was eminently true in this case. For many weeks be- 
fore the actual occurrence of a case of cholera — " bowel 
complaints" were almost the only disorders, for which we 
were called upon to prescribe — or, if any of the usual dis- 
eases of the season occurred, diarrhoea was sure, sooner or 
later to manifest itself, and demand prominent attention. — 
Here, as elsewhere, the diarrhoea, which was so prevalent 
before and during the continuance of the cholera, and which, 
to be truly estimated, must be regarded as the forming stage 
of that fearful disease, was unaccompanied by pain, and, be- 
cause painless, was often allowed to proceed to a dangerous 
extent, before advice was asked, or proper treatment 
adopted. 

There was no unusual difficulty in the treatment, when 
commenced upon the first appearance of the disorder. Opium 
in some form or other, was an essential ingredient in every 
prescription. After trying various combinations, I gave the 
preference to opium, ipecac : and acet: plumb: (opii. i to $ 
gr. ipecac: 1-6 acet: plumb. 1 gr.) These pills given every 
two hours, or at longer intervals, with simple unirritating diet, 
constituted for the first few weeks almost a routine treat- 
ment. But as the season advanced, and the invasion of the 
cholera became more imminent, these ^attacks were more 
frequent and obstinate. It became necessary to confine pa- 
tients strictly to the horizontal position. Calomel was sub* 



244 dr. .gibbon's report, 

stituted in the above prescription for the acet: plumb: with 
good effect. 

In regard to the treatment of cholera, I may say briefly, 
that in the few cases which came under my care, the rice- 
water discharges were more promptly arrested, by injections 
of tine: opii: and starch, (60 to 80gtt. to 2§) than by any 
other means. These injections to which I resorted, in al- 
most every case with cal: and opium — sinapisms to the epigas- 
trium— warmth, and dry frictions to the extremities, and 
liquid ingesta to repair the waste of serum, constituted the 
sum of my treatment." 

Intermittent fevers were very prevalent early in the 
spring of 1849. They were generally of the tertian type, of 
a mild character, and easily managed by bark and quinine. 
Upon the decline of the cholera, the autumnal intermittents 
prevailed more extensively, than for many years previous- 
ly. They were mostly tertians and quotidians— were more 
intractable than in the spring, and extremely liable to run 
into remittents, and especially so when purgatives were too 
freely used. Diarrhoea was a frequent symptom. Bark and 
quinine were of less efficacy than usual in their treatment. 
Relapses were more frequent than in ordinary seasons. 

Remittents were also unusually prevalent. They were 
generally of a mild, and in many instances of a mixed cha- 
racter. The symptoms being imperfectly developed, it was 
difficult to decide, whether they partook more of the remit- 
tent or intermittent quotidian forms. As in the case of in- 
termittents, great caution had to be used in the administra- 
tion of purgatives, during their treatment. Diarrhoea, and 
typhoid symptoms readily appeared upon the exhibition of 
any other than the mildest cathartics. Fomentations and 
blisters to the abdomen, formed in many instances an essen- 
tial part of the treatment. 

Pleurisy and pneumonia were frequently observed during 
the latter part of the winter and early spring. The leading 
peculiarity of these diseases, was their frequent complication 



dr. gibbon's report. 245 

with gastric and hepatic derangement. Though apparently 
of a sthenic character, general depletion did not exert its 
usual control over the early symptoms. Antimony, as a 
general rule was badly borne, aggravating the gastric irrita- 
bility, where it existed. The treatment practiced by your re- 
porter, most satisfactorily, consisted of small bleedings, fol- 
lowed by a mercurial purge at the onset — the latter repeat- 
ed occasionally, during the progress of the disease. Subse- 
quently, calomel, in alternate doses combined with opium or 
Dovers powders — or antimony in minute doses, where the 
stomach and bowels would bear it; and blisters followed by 
fomentations, were resorted to with benefit. 

Hooping-cough made its appearance late in the winter, 
and still continues to prevail. In its uncomplicated forms it 
assumed a mild character : but when combined with pulmo- 
nary inflammation, it proved very intractable, and in a num- 
ber of instances fatal. The treatment of the milder and sim- 
ple forms of the disease, differed in no essential particular, 
from that ordinarily pursued. Your reporter prescribed cof- 
fee, as recommended by Dr. Guyot — in several cases with 
very marked benefit. When combined with pleurisy and 
pneumonia, (a frequent occurrence,) the treatment already 
spoken of under the head of those diseases, was practiced 
with success. 

Measles and catarrh, were occasionally witnessed in the 
spring of 1849, and the latter prevailed very generally, dur- 
ing the winter, and the present spring. There were some 
sporadic cases of rheumatism during the winter. The only 
thing worthy of remark, in the treatment of these diseases, 
was the fact already several times alluded to in this report, 
viz : that purgatives were, unless prescribed with more than 
ordinary caution, liable to excite troublesome diarrhoea. If 
the experience of your reporter be correct, bronchocele 
would seem to be on the increase in this district; four 
cases having occurred in his practice, during the past year. 
The result of the treatment adopted in those cases was high- 



246 dr. gibbon's bepobt. 

ly satisfactory. Iodine was the only remedy employed. It 
was given internally, in the following formula, viz: 
R. Iodine 48 grs. 
Alcohol 5j 

Of this solution, the patient took ten or twelve drops three 
times a day, at the commencement, and the quantity was af- 
terwards gradually increased to twenty or thirty drops. The 
iodine was also employed externally, in the form of tinc- 
ture, (30 grs. to |j.) Under this treatment, all of the cases 
except one, recently seen, and now under a similar treatment, 
speedily exhibited signs of amendment, and are now appa- 
rently well. 

The tone of public sentiment in regard to quackery, is 
slowly improving in West Jersey, if we may judge from the 
experience of the past year. The refusal on the part of our 
State Legislature, to entertain the proposed amendments to 
the existing statutes, in regard to illegal practitioners, has 
been very generally approved by the intelligent portion of 
the community in this district. Homeopathy seems to have 
been the most prominent of its forms, during the past year, 
in your reporters' immediate neighborhood. Thomsonian- 
ism is gradually becoming extinct. Your reporter regrets 
however, to say, that the disposition to purchase and use the 
various nostrums of the day, seems to be but little, if any 
abated. A principal cause of this is, in the opinion of your 
reporter, owing to the practice among druggists of not only 
selling, but also personally recommending quack medicines; 
a practice deeply to be regretted, inasmuch as it interposes 
a serious obstacle to the cultivation of correct public senti- 
ment, in regard to the rights and responsibilities of medical 
men. 



ABSTRACT OF SUPPLEMENT B¥ DR. ELMER. 

Catarrh, Remittents, and Scarlatina, were occasionally seen 
in Bridgeton during the spring. They were generally of a 



dh. elmers' report. 247 

mild form. Early in June, affections of the bowels began 
to prevail. Diarrhoea in children, and dysentery in adults, 
were very frequent. These were most successfully treated 
by purgatives of calomel and castor oil — followed by "sooth- 
ing and astringent remedies." During the latter part of this 
month, dysentery increased in frequency and severity. The 
cases, however, soon recovered under the above mentioned 
purgatives, followed by Camph: Opii: and Ipecac: conjoined 
occasionally with mucilaginous and anodyne injections. 

In July, cholera epidemica made its appearance, charac- 
terized by rice-water stools, cramps, extreme prostration, 
coldness of the surface, &c. &c. The " most efficient treat- 
ment seemed to be, to arouse the system by external stimu- 
lants and friction;" large doses of calomel ; "no stimulants 
internally, and to check the rice-water stools when copious, 
by suppostories of opii. and acet. plumb. Bleeding in seve- 
ral cases seemed to aid reaction" The nervous symptoms 
seemed to be benefitted by the use of Camph: HofF: Ano- 
dyne, and Carb: Ammon: Protracted debility followed the 
severe cases, and required the liberal use of both vegetable 
and mineral tonics to restore the patient. "If there was 
any one remedy, upon which we might lay more stress than 
others in the treatment of this scourge, I should certainly 
say calomel — its action was so prompt, and so decided in 
changing the whole aspect of the disease." 

Phthisis, is on the increase in this section. Dr. E. has de- 
rived but little benefit from the use of Cod Liver Oil, in its 
treatment : but has been much pleased with the effects of 
Wood Naptha ; two cases having recovered under its use, 
in one of which, a cavity had formed, and in the other tu- 
bercles had softened, and been expectorated. In other cases, 
it seems to have kept the disease at bay. He recommends 
xxgtt. to be given daily, with Syr. Scilla: and Tine: Opii: 
Camph: 

There were few or no births in his section, during the pre- 
valence of the cholera : a fact, which he says, was observed 



248 dr. garrison's report. 

during the prevalence of a congestive fever in Bridgeton in 
the autumn of 1841. I think we have observed a similar 
fact, though not perhaps in so marked a degree in this 
neighborhood. Certainly, there were a greater number of 
abortions than usual, during the past summer and autumn. 
Salem, April 25th, 1S50. 



ABSTRACT OF REPORT FROM GLOUCESTER COUNTY. 
BY JOSEPH F. GARRISON, M. D. 

The formation of the American Medical Association seems 
to have given a new, and we hope favorable impulse to the 
profession, and should its future proceedings be character- 
ized by the same spirit which has thus far marked them, 
they will soon exert a decided and beneficial effect upon the 
community without. 

In 1847, our county society was reorganized, and has since 
then, been conducted with increasing interest. From the 
reports made by the members at each meeting, I shall lay 
before you a sketch of the diseases which have been most 
generally prevalent among us during the past year, treating 
of them in the order of their succession. 

In the latter part of the winter of '48, and the spring of 
'49, we were visited by the influenza. In some of its vari- 
ous forms, and with more or less severity, it attacked almost 
every person in the community. In some sections of the 
county it was preceded by a disposition to croup among 
the children, which was in many cases exceedingly obsti- 
nate. It came on gradually, and progressed slowly. An 
occasional metallic sound in the cough indicated to a prac- 
tised ear the presence of the fearful disease ; but the parents 
were often unconscious that the child was in danger until it 
was almost beyond the hope of remedy. In certain districts 
the mortality was considerable, much greater than ordinary, 
no plan of treatment being successful in averting a fatal ter- 



dr. garrison's report. 249 

mination. If seen early, the patients were bled — full use 
was made of emetics. Ipecac: antimony, and sulph: of cop- 
per were in turn called into requisition — the system was as 
rapidly as possible put under the influence of mercury, and 
the fauces were washed with solutions of nitrate of silver. 
These means, singly or united, according to the indications 
of each particular case, formed our main reliance in this dis- 
ease. We occasionally used blisters to the thorax, and ap- 
plied warm fomentations to the throat. Dr. Fithian, of 
Woodbury, not satisfied with the results of the ordinary 
mode of treatment, had recourse to the use of cold water to 
the throat and upper part of the chest, by dipping a towel 
in the water, folding it to fit the throat, and binding it on 
with a strip of cloth or flannel. We used it in four cases — 
relief in every instance followed its first application. If the 
symptoms became aggravated again after several hours, it 
was renewed and the ultimate results were most satisfacto- 
ry, all of the patients recovering. 

Closely following this croupy tendency in children, the 
influenza appeared among adults, and during the rest 
of its course seemed chiefly to attack those of the mid- 
dle periods- of life, children being less troubled with affec- 
tions of the thoracic organs than usual at the same season of 
the year. 

The influenza came on generally with a chill, followed 
by pains in the back, head and limbs. These were often 
shifting in their character, and accompanied with considera- 
ble fever; there was an unusual amount of soreness in the 
muscles, and aching in all the joints, causing the patient to 
cry out if he was roughly moved or handled. In some 
cases these were the only symptoms present. Nothing 
marked any particular organ as the especial seat of the dis- 
order ; but commonly after a day or two there was a dry 
cough, soon followed by expectoration of mucous alone, or 
streaked with blood, or the pain would all seem to centre in 

the side ; or a diarrhasa, with soreness and pain of the abdo* 
32 



250 SB. garrison's report* 

men, would make its appearance, and the disease would as- 
sume unequivocally the character of a bronchitis, or pneu- 
monia, and in some instances pleurisy, or irritation of the 
bowels — these were sometimes singly present, but more 
frequently the patient was at the same time suffering from 
the effects of two or more of them combined. This disease 
was generally very manageable, and the mortality slight. 
In our own practice we seldom thought the lancet necessa- 
ry, and were sparing in the loss of blood, except in those 
cases where there was a very decided tendency to pneumo- 
nia or severe pleurisy. But some of our members employed 
v. s. in a large proportion of the cases where the disease was 
fully developed in any of its forms, and they thought with 
advantage, maintaining that their cures were more rapid 
and complete, than where the lancet had been abstained 
from or less generally used. In some cases where the en- 
teric affection would admit its use, we all employed antimo- 
ny for the control of the thoracic diseases ; and where its 
use was restricted or negatived by a disorder of the bowels, 
calomel in combination with ipecac: or Dover's powder was 
found to answer a most admirable purpose ; it seemed to us 
to exercise a more powerfully controlling effect over the in- 
fluenza, in all its varieties, than any — we had almost said 
all other remedies combined. Wherever antimony was in- 
dicated, calomel, in connection with it, was beneficial, and 
in many instances where antimony was inadmissible, the 
mercurial was found to be of inestimable service. Where 
the thoracic symptoms did not quickly yield to internal re- 
medies, we used blisters much sooner than we are accus- 
tomed to apply them, but we found them a signal benefit in 
many instances even at a very early period of the disorder. 
After the subsidence of the influenza the county was 
very healthy until about the middle of June, when the cho- 
lera made its appearance among us. The first case was a 
fisherman, at Red Bank, on the river shore, about three miles 
from Woodbury. He was in the employ of a Mr. Bake- 



dr. garrison's report. 851 

oven, and resided at Port Richmond, Pa. One of the same 
company had been taken ill there and died about three days 
before, and was reported by Dr. Janvier as the first case of 
cholera which occurred in Philadelphia. After his death his 
comrades who had been with him during his illness came 
down to Red Bank, where the fisherman was taken with 
the disease and died in a very few hours. From this time 
the influence of the epidemic seemed to be abroad over all 
the land. There was scarcely an individual who did not 
experience the effects of it ; the tendency to diarrhoea was 
universal; its attacks were easily induced, exceedingly and 
rapidly prostrating, and disposd to return every few days, 
even where it was most carefully watched ; so that it seemed 
to affect the breath, and destroy the energy of the whole 
community ; every one complained of feelings of unusual 
debility and depression of ail the vital powers — laboring 
men were unable to work, and would often apply for some- 
thing which would make them strong, stating that they were 
not sick, but found it impossible to carry on their accustomed 
labors. In such instances, there was nothing indicative of 
disease excepting this languor, and a slight tenesmus, which 
led them to attempt a passage of the bowels several times a 
day; though frequently there would be only one, or at most 
two stools in the course of the day and night. It was not 
unusual to have the patients complain entirely of the head; 
the face was flushed and the eyes watery, and pain of con* 
siderable severity occupied the forehead, or the whole head 
felt full and very uncomfortable. There was no pain or 
soreness of the abdomen, and no diarrhoea was spoken df, 
but if particular inquiry was made, it was found that there 
had been several stools in the last twenty four hours — and 
treatment directed entirely to the controlling of this, soon re- 
lieved all the symptoms of the disorder within the cranium* 
The diarrhoea which prevailed at this time so extensively 
was not in general attended with much pain or abdominal 
tenderness, although there were many exceptions to this— 



252 dr. garrison's report. 

but it rapidly induced the most complete and distressing 
prostration ; and after it had continued for a short time a 
peculiar leaden color, and haggard expression of counte- 
nance marked the ailment under which the patient was suf- 
fering, as unmistakeably as any combination of symptoms 
could have done. Cramps in the extremities, or the muscles 
of the abdomen were common in these cases, and if the diarr- 
hoea was not soon checked, vomitting came on, the cramps 
grew more severe, the discharges from the bowels lost their 
feculent character and became watery and colorless; the 
hands and feet were cold ; the leaden color of the face be- 
came deeper and darker ; the skin upon the fingers was 
wrinkled and bluish ; the eyes lost their natural expression, 
and looked dull and heavy ; the voice was faint and husky; 
the respiration embarrassed ; the pulse at the wrist feeble, 
fluttering, or entirely wanting ; and the patient was over- 
whelmed with all the symptoms of the collapsed stage of the 
Asiatic cholera. Cholera morbus was frequent, coming on 
suddenly, and with considerable severity, but it seemed 
much more manageable when thus attacking an individual, 
than when it succeeded to a previous diarrhceal stage. In 
several instances we observed a disposition to disorder of 
the kidneys in these diarrhceal cases; pain in the back, 
more frequent calls to urination than usual, and pains along 
the course of the anterior crural nerve, which subsided as 
the other symptoms yielded to treatment. The violence or 
duration of the premonitory diarrhoea did not seem to afford 
any measure of the severity of the menaced attack ; but in 
every case of choleraic collapse which came under my no- 
tice, there had been a previous diarrhoeal period, and in 
every instance of sufficient duration to have been affected 
by proper remedies, had they been employed. 

The treatment of these cases was very uniform through- 
out the whole county. The means used in brief, were warm 
applications to the extremities, and also (in connection with 
sinapisms) over the bowels ; ligatures around the limbs were 



dr. garrison's report. 253 

recommended by some for controlling the cramps ; and the 
discharges were promptly checked by the use of astringents, 
with small quantities of opium in slighter cases ; and in the 
more severe, with the addition of calomel, and larger doses 
of opium repeated often enough to quiet the pain and re- 
strain the number of discharges ; a grain of opium every 
•one, two or three hours until it had produced the desired 
effect. Where the cholera morbic symptoms were fully de- 
veloped in constant nausea, and vomiting, added to the purg- 
ing, we* relied upon the more frequent administration of 
pills of opium and calomel. When the case was seen early, 
this succeeded perfectly in arresting its progress: but in 
those instances where the disease ran on for several days 
with a persisting diarrhoea and disposition to sick stomach 
and vomiting, we used opium freely through the day, giv- 
ing at bed time a full dose of calomel, say 6, 8 or 10 grs. — 
repeating it every night till it was followed by dark colored, 
consistent bilious stools, from which time the patients were 
rapidly relieved, endeavoring to control the stomach by ad- 
ministering in the intervals, brandy, the mixture [of vine- 
gar, capsicum, salt and water] or the swallowing of pieces 
of ice, which latter sometimes had a most beneficial effect, 
refreshing the patient, and checking the nausea. In two 
cases which occurred in the practice of Drs. Fithian and 
Saunders, of Woodbury, where the symptoms were those of 
rapidly approaching collapse, they arrested the course of the 
disease very speedly by the use of a solution of nitrate of 
silver in water ; both the patients had taken opium previ- 
ously — the one gr. vi. in pill, and the other gr. iv. in tinct: 
camphor — but without causing any amendment. Dr. Saun- 
ders gave to the one, gr. 2§ of the nitrate in an ounce of 
water ; the nausea was removed directly, and there was na 
vomiting after the administration of the medicine. To the 
other Dr. Fithian gave gr. i. of the nitrate in an ounce of 
water, with a similar result. In this case, however; the pa- 
tient took gr. iij. of opium after the nitrate, This remedy 



254 dr. garrison's report. 

has been highly recommended for controlling irritability of 
stomach, and would seem to be worth a trial in such cases. 
Dr. Howell read before our Society, and subsequently pub- 
lished in the New Jersey Medical Reporter, an account of a 
case of cholera morbus, of unusual severity, which was 
checked by its use. In the instances above referred to, the 
relief afforded followed so immediately its administration 
that the gentlemen who employed it were sanguine in their 
expectations that it would prove a valuable addition to our 
means of checking these most distressing symptoms; but as 
it was used by both, in connection with large quantities of 
other powerful remedies, a full and careful investigation into 
its powers when used alone, and of the cases to which it 
may be adapted, is needed before we can give any well 
founded opinion as to its value as a remedial agent in con- 
trolling the disease. 

Notwithstanding the disposition to disorder of the bowels 
which prevailed to so great an extent throughout the whole 
of our county, we had very few cases of a dysenteric char- 
acter till towards the close of the epidemic, excepting only 
the neighborhood of one town, Clarksboro', in, and around 
which it raged with unusual violence and mortality during 
almost the whole of the summer. But in the other sections 
of the county, there was very little of it till near the decline 
of the choleraic influence. In the latter part of this time 
however the majority of our cases seemed to put on a dy- 
senteric appearance, sometimes being marked by considera- 
ble severity in their progress, but with a very slight fatality 
in their results. In the treatment of it, the lancet was very 
seldom used ; and no purgatives were employed excepting 
calomel, and occasionally castor oil after the calomel. Opi- 
um was considered the chief reliance, and it was used with- 
out stint There were three plans of treatment followed by 
different members of the Society, but they were dissimilar 
only in the mode in which they employed the same reme- 
dies. By some, the opium was given in combination with 



DR. GARRISONS REPORT. 255 

calomel, in divided doses, every three or four hours, using 
as a vehicle, powdered elm bark or some other mucilage, 
continuing the combination regularly till bilious stools were 
produced. Others used opium alone through the day, giv- 
ing a grain or more of it at such intervals as would suffice 
to quiet the pain and check the discharges ; and at bed time 
gave a full dose of calomel, ten grains, with about two or 
three of opium, and then stopped all medicine till this had 
purged once or twice, when the opium was resumed as be- 
fore ; and lastly, the calomel was given in castor oil, or fol- 
lowed by the oil very shortly, and when this had purged, 
then opium, or opium and calomel combined, were adminis- 
tered at intervals of three or four hours. In our own prac- 
tice we thought that the second of these plans succeeded bet- 
ter than either of the others. Where there was much tormi- 
na and tenesmus, nothing controlled them so well as enemata 
of mucilage and laudanum. 

Since the close of the warm weather, and the departure of 
the epidemic, the county has been unusually free from all 
disease of an epidemic character — and even sporadic cases 
have been very few. Our cases of autumnal fever were few 
and light, and during the winter thus far, there has been an 
almost total absence of the thoracic diseases, peculiar to the 
season of the year — and those which have occurred have 
been very mild — there has been a much stronger tendency 
to neuralgia than to inflammatory affections, and even where 
inflammation was present, the neuralgic elements of the dis- 
ease seemed to preponderate over, and outlast the others — 
all the constitutional symptoms would subside long before 
the pain had left the affected part. In almost all the cases 
however, there has been a decided disposition to diarrhoea 
so much that we have been obliged to be very guarded in 
the use of antimony and purges. 

From the absence of all factories, or public works of any 
kind, we have very little surgery to report in this district ; 
the only case which deserves any notice, is an operation for 



256 dr. garrison's report. 

strangulated femoral hernia, which was successfully per- 
formed by Drs. Clark and Weatherby, upon a female patient 
of the latter. She was put under the influence of chloroform 
during the operation, and recovered very rapidly after the 
replacement of the bowel. 

Much interest has lately been manifested through the me- 
dical journals and societies, in the discussion of the connec- 
tion between pregnancy and albuminuria, and the influence 
of this latter in the production of puerperal convulsions — the 
following case fell under my observation a few months since, 
in which the first two of these states existed coincidently, and 
as it may illustrate some points in the history of this formid- 
able combination, I send it to you as the only item of inte- 
rest which I have to report on the subject of midwifery. 

Dr. Charles Garrison was called on the morning of August 

31, 1849, to see Mrs. L , with flooding — the patient was 

about 40 years of age, and the mother of several children — 
she had generally enjoyed good health, until some four 
years ago, at which time, she suffered from the recurrence 
of severe attacks of colic — these were arrested by a slight 
mercurial course, and have never been repeated — for the 
last year or two she has been gaining flesh very rapidly — 
but has not felt like one in vigorous health, and has had oc- 
casional abortions, the number I do not know ; during the 
past two months, she, in common with those about her, 
suffered from several severe attacks of the prevalent diarr- 
hoea which were checked by the use of opium and as- 
tringents — but the disposition to it was so strong that it has 
at no time been completely arrested ; for some months, her 
feet and ankles have been slightly oedematous, and latterly 
the swelling has extended to her hands and face, and is now 
present over the whole body — her discharges of urine have, 
during the same period, been both less frequent and less co- 
pious than usual. At the time that my father first visited 
her, she was about eight months advanced in pregnancy — 
she had been taken a few hours previous to his seeing her, 



dr. garrison's report. 257 

with pain in the back and hemorrhage from the uterus. She 
had not lost much blood, and the discharge was soon arrested 
— but she was in a situation which indicated extreme dan- 
ger — the cellular tissue over the whole body was infiltrated 
and distended — the hands and feet were very much swollen, 
and such was the oedema of the face, that its natural appear- 
ance, and expression were entirely changed — the lips and 
cheeks were livid, and the eyes dull and bloodshotten — she 
complained of pain in the head — and dimness of vision — 
had been vomiting during the night, and still had constant 
and distressing nausea ; the skin was cool and pasty to the 
touch, and the pulse very feeble. Her feelings were those 
of extreme weakness, and on the slightest motion she had 
a disposition to fainting. [Ice was applied to the head, and 
she was kept quiet.] During the next two days she seemed 
somewhat better, the head was less painful, and her face 
and hands less oedematous. On the 5th day of her illness, I 
first saw her (Sept. 3) — her bowels had been freely moved 
just before my visit, and she expressed herself much relieved 
— the pain had left her head and back and she felt more easy 
and less weak, but still there was a dimness in her vis- 
ion when she attempted to discern objects, looking as if 
there was a veil before her eyes : pulse 80, but easily com- 
pressible and very feeble. On examining her urine, I found 
it acid in its reaction, of a reddish color, without any mu- 
cous flocculi or sediment ; the addition of nitric acid and the 
test by heat, showed the presence of an immense proportion 
of albumen — the vial was nearly filled with the precipitate, 
I have never seen so large an amount of albumen thrown 
down from the same quantity of urine — [R. Carb, Potassse 
and diuretic infusion, and continue cold to the head.] 

September 4th— After my visit of yesterday, diarrhoea 
attended by constant nausea and disposition to vomit had 
come on, face more swollen, complains of feeling ex- 
tremely weak, has been faint all day, and at times seems 
almost totally exhausted, and unable to rally, has also some 

slight pains diffused through the head, but none elsewhere, 
33 



258 DR. RODGERS's REPORT. 

[Sinapisms to neck, cold to the head. R. lime water- 
cream and ice, and kino for her diarrhoea.] 

September 5th and 6th. — Sick stomach an^ diarrhoea bet- 
ter — otherwise not much change ; the appearance of the 
eye heavy, with a wandering and uncertain expression ; 
the swelling is gradually increasing — urine still small in 
quantity, and highly albuminous. 

September 7, 8 and 9th, seems to be sinking gradually ; 
with little change in the symptoms, but a great increase 
of debility, pulse 100, to 120, and failing in force some- 
times, being scarcely perceptible for a considerable period. 

September 10th. — Labor came on this morning suddenly, 
with the discharge of a large quantity of liquor amnii ; pain 
followed directly, and before my father reached her, the child 
and after birth were both expelled. This was not followed 
by any hemorrhage, but there soon seemed to be a still 
more entire prostration of all the energies of the system ; 
the eyes were affected with a slight strabismus, but there 
were no convulsions ; from this time she rapidly sank, and 
died in the evening. This case was marked with all the 
characters of a poisoning of the system, from the presence of 
some impurity in the blood, and indicates strongly the ne- 
cessity that we should watch in all cases of pregnancy 
which are placed under our care, lest our patients should 
suffer from this addition to the dangers of that perilous state, 
until it is too late for any remedy to be of service. 



ABSTRACT OF REPORT FROM ESSEX AND PASSAIC. 

BY ALEXANDER W. RODGERS, M. D. 

Being without information from other localities, the Re- 
port for the Eastern District has reference only to what has 
been observed of the course of diseases in the counties of 
Essex, and Passaic ; and more particularly in the vicinities 
of Newark, and Paterson. 

During the whole of the past year, the diseases have been 



DR. RODGERS's REPORT. 259 

more asthenic than usual, few requiring blood letting, or 
free depletion by purgation, and those only, in the earliest 
stage of their course. The tendency has been to early pros- 
tration, and lingering debility. 

We think proper to insert a short account of the weather, 
before our notice of the diseases of spring and summer. 

April was dry and cold ; the prevailing winds were North- 
west and West. In May, cold, sluggish, dull, lowering 
weather, with easterly winds prevailed. The mean tem- 
perature was 55%°, being 4° below the average for the last 
six years. About the fourth day of the month, there was a 
change of more that t 36° in less than twelve hours, preceding 
rainy and cloudy weather. 

In April and May, the prevalent diseases were inflamma- 
tory affections of the lungs, chiefly of a bronchial kind.— 
Many of these cases became chronic. The subjects of many 
of them were children. Some proved fatal, and others only 
recovered, after reducing the little patients to the last extre- 
mity. The bronchial disease, was sometimes complicated 
with irritation, or a low degree of inflammation of the mu- 
cous tissue of the alimentary canal ; and with this disease 
of the mucous tissue, there was also often more or less affec- 
tion of the head, simulating the approach of hydrocepha- 
lus. These were tedious and difficult to manage, gentle 
alteratives and tonics, proved of most avail. Sometimes in 
the latter stages, small doses of nitric acid appeared to have 
a salutary effect upon the diseased mucous tissue, and to 
promote general strength. 

Pleurisies and Pneumonia, were also frequent. In some 
of these cases, the impotency of blood-letting to subdue the 
disease was strikingly manifest ; while the good effects of 
blistering and other counter-irritants, were equally manifest. 
We have observed, that in almost all cases of pulmonary in- 
flammation, after moderate depletion by the lancet, counter- 
irritation operated well, and was almost essential to the cure. 



260 D.R RODGERs's REPORT. 

We here insert a short notice of weather during the sum- 
mer. 

The average temperature of June and July, was higher 
than for several years past, also higher than in 1832. Dur- 
ing the first half of June, the average was about 75°, and 
during the latter half of that month, it was over- 85°. The 
atmosphere, however, was heavy and more chilly to the 
sense than usual, and there was less rain than in any June 
for the last six years. From the 17th to the 27th, the 
weather was unusually hot and dry. In July, there was 
great heat in the middle of the day, and the nights were cool- 
er than usual in proportion. From the 1st to the 11th, the 
thermometer ranged from 75° to 80° during the day. On 
the 11th it rose to 87i°, on the 12th to 97°, and on the 13th 
to 99f °. On the 14th it was 97^°, and on this day the sky 
clouded. But while there was a heavy rain south of the 
Raritan, only a few drops fell here. The temperature, how- 
ever, fell 40°, and on the 15th and 16th, continued colder by 
20° than before the change. During the remainder of the 
month the mercury rose daily above 81°, and on the 20th, 
26th, and 30th, as high as 88°. During the greater part of 
the day the winds were brisk, and in the latter part of the 
day generally easterly. 

August was characterized by more rain, a more equable 
temperature and clearer atmosphere. There was less than 
9° difference between the mean of the warmest and the 
coldest days. The mean of the month was a fraction over 
72°. The winds during the early part of the month, were 
variable, but during the last week, they were almost con- 
stantly easterly. The past summer was warmer than any 
of its predecessors, since 1845. 

In the latter part of May several cases of sudden and se- 
vere diarrhoea, with great faintness, prostration and coldness 
of surface were observed. These cases had an unusual 
tendency to relapse, after being checked. At a later period 
when the cholera was admitted by all to be among us, these 



DR. RODGERs's REPORT. 261 

cases would have been reported as decided cases of that dis- 
ease. 

The first cases of Cholera reported as such, appeared in 
this part of the State the last of May. The first case in Pa- 
terson, occurred on the 30th of May, and the first in Newark 
on the 31st. From the time of its appearance, till near the 
middle of July, but few cases occurred. In June, there 
were but four deaths in Newark, and but five in Paterson ; 
and from the 11th of June till the 5th of July, it was entire- 
ly absent from the latter place. On the 5th of July, it ap- 
peared again in Paterson. One case occurred on this day — 
others on the 10th, and from this date till the middle of 
August, the disease prevailed with considerable severity ; 
and from that time till the 10th of September, with dimin- 
ished force. After the latter date, no case was seen in this 
vicinity. The whole number of deaths in Paterson, were 
one hundred and nine. The number of cases supposed to 
be less than double the number of deaths. In the city of 
Newark, from the 10th to the 24th of July, but nine deaths 
were reported ; but during the last week of the month there 
were seventeen deaths, twelve of these occurring on the 
29th and 30th. The whole number of deaths during the 
month, was thirty-one. In the first two weeks of August, 
forty-seven deaths were reported, and as near as we have 
been able to learn thirty -two occurred during the remainder 
of the month, making the whole number for August seven- 
ty-nine. During the early part of September, but a very 
few cases appeared. 

The pestilence visited the Newark Alms-house, situated 
a mile and a half below the city, on the 18th of July. In 
the first six days there were eleven cases, and six deaths, and 
during the remaining days of the month, eighteen more 
deaths occurred : and three more in August. 

We have not been able to obtain the whole number of 
cases which appeared, either in the city or the Alms-house, 



262 DR. RODGERs's REPORT. 

but in regard to the city, we have learned enough to judge 
of the fatality of the disease. During the first two weeks of 
August, there were seventy-one cases to the forty-seven 
deaths, showing a mortality of nearly two-thirds. In the 
early part of August, the disease suddenly appeared in the 
neighborhood of Bloomingdale, Passaic county, and carried 
off seven of one family, in the course of three days. We do 
not know that others beside the fatal cases occurred. 

The epidemic appeared in Rahway, the 8th and 9th of 
July, and at its onset, the cases succeeded each other with 
fearful rapidity. Full two thirds of these died, but after a 
few days the disease almost disappeared ; and although it 
returned in the latter part of the month, it prevailed with 
far less malignity. The extent of the ravages of the disease 
in Jersey City, we do not know. We believe that no cases 
occurred in Plainfield, and few or none in Elizabethtown ? 
nor in any of the other towns in the district. Some deaths 
occurred in various localities, of those who had been visit- 
ing in the cities where it prevailed epidemically, and were 
seized by it soon after returning home. 

As far as your reporter has become acquainted with the 
facts, no connection could be traced between many of the 
first cases of the disease. It is true, that in nearly all of the 
families in which one case appeared, others followed, but 
they were not generally those who were most exposed to 
the first case : but more often those who were but little with 
the patients. It was observed, that when one case occurred 
those relatives who were much stricken with fear, were very 
apt soon to fall victims of the dread malady. 

We do not know that in this district, any particular care 
was taken to insulate the sick from the well. 

The mortality as stated above, (the deaths being to the 
cases, as two to three,) was very great ; but this must not 
be considered the proportion, when medical aid was ob- 
tained, in the early stages. As far as we know, in such 



DR. RODGERs's REPORT. 263 

cases, not more than one-third proved fatal, although the 
disease was sufficiently advanced to make its character un- 
mistakeable. 

The subjects of the disease were chiefly persons in a low 
condition of life ; many of them, of intemperate and irre- 
gular habits, and those who were subject to much fatigue 
and exposure, with poor fare. When individuals of a com- 
fortable, regular mode of life, and temperate habits, became 
its victim, some exciting cause — such as excessive fatigue, 
imprudent diet, or more than usual dread of the malady, 
was almost always present. Those persons who were af- 
fected with chronic dyspepsia, and derangement of the ali- 
mentary canal, and biliary organs, as might be expected, of- 
ten fell victims. Cases which appeared at first as common 
cholera morbus, and also dysentery not unfrequently ended 
in cholera. 

In Paterson, the disease was more rife in the lowest and 
most crowded parts of the town. During the period of its 
greatest severity, it appeared to progress from south to 
north. 

The course of the disease differed but little from that 
of the epidemic of 1832, but we think the cerebral af- 
fection was more apt to follow a partial collapse than in 
1832. In that epidemic, as we saw in New York city, 
the consecutive fever, with the affection of the brain, 
was not often seen, except after complete collapse. In the 
recent epidemic, the majority of young persons and children 
had consecutive fever, even when there was but an ap- 
proach to collapse. 

We are not aware that any thing new was learned by us 
in relation to the essential nature of the disease, or its proxi- 
mate cause. But while this may be still a matter of hypo- 
thesis and speculation, we all agree that an essential part of 
the disease, is a determination of the vital fluid to the intes- 
tinal surface, with a reflux from the cutaneous surface and 
the extremities of the system, and with these, an inactive 



264 DR. RODGERs's REPORT. 

state of the function of the liver, and our treatment has 
been mainly directed to the counter-action of these abera- 
tions. Perhaps the foregoing conditions were preceded by a 
depressed state of the nervous system ; for it was certain that 
agents which could operate in no other way than through 
the mind had much to do, both as causes and remedies. 
Those cases that were most amenable to treatment, were 
individuals not the most robust in constitution, but often 
those who were rather feeble. The hopes and fears of the 
patient, had much to do with the success of the physician. 
And it was observed that, if a rather nervous and sensitive 
patient could be inspired with confidence and hope, such an 
one was far more likely to recover, than one of a mental 
temperament more obtuse, and less susceptible to spiritual 
influences. We thus account for what we know to be a 
fact, viz: a greater number of recoveries among female pa- 
tients. 

In the early stages of the malady, some physicians tried 
venesection, and thought its effects salutary. Dr. Dougherty, 
of Newark, says — "In a number of instances, free bleeding 
seemed to have the happiest effect in preventing collapse, 
even when it was evidently impending. 

"One man, whom I saw, had been taking l Loweree's 
cholera mixture' all night, till morning found him with vox 
cholerica, hippocratic face, feeble pulse, and cold surface.— 
At the first v. s. the blood was black and flowed sluggishly, 
— -at the second, several hours later, it was red, and flowed 
freely. A pregnant woman with the same symptoms was 
equally and similarly relieved. 

These, with other cases that it would not be worth while 
to detail, prove to my satisfaction the value of this agent, 
when early used." 

The Dr. does not say whether in these cases other reme- 
dies were used at the same time, but we suppose they were. 
In the stage of collapse, he says, that " bleeding was at least 
nugatory, if not hurtful." 



DR. RODGERS's REPORT. 265 

Most physicians in this vicinity, made use of external ap- 
plications, with a view of keeping up the heat of the surface 
and inviting the blood to the cutaneous capillaries. Some 
thought friction best — others preferred to keep the surface 
closely covered. As far as we observed, the latter mode 
was far the best. The tendency to coldness of the surface 
was so great, the exposure appeared to carry off more heat 
than the friction induced. In our practice, hot dry applica- 
tions, (and we prefer bags of heated salt), kept closely ap- 
plied to the extremities and sides of the body, appeared to 
assist materially in keeping up the heat and in relieving 
cramps. The latter symptom we found full as much re- 
lieved by firmly grasping the limbs through the bed clothes, 
as by friction. The hot salt relieved the cramps of the bowels, 
as much as any external remedy we ever used. Mustard 
plasters were often applied to the surface with good effect. 
A spice plaster, made of strong ginger, cloves, &c., with hot 
brandy, we often used with benefit over the pit of the sto- 
mach, in the early stages. When collapse was com- 
plete, hot applications to the surface appeared to us to do 
little good, and as they oppressed the patient, were often 
discontinued. 

Of internal remedies, a great variety were used, and often 
of a very opposite kind, even by regular practitioners. — 
Stimulants, (in moderate doses) carminatives, and astringents, 
were generally admitted to be useful both before, and in 
collapse. But we often saw stimulants and hot spices used 
to excess, and thereby inflammatory affections of the sto- 
mach and bowels induced, that were not easily recovered 
from. Opiates in the early stages, were often very happy 
in their effects, and essential in the treatment. But these 
likewise, could be easily carried to excess, so as to induce 
consecutive affections of the brain, and thereby do as much 
harm as good. In collapse, opium appeared to increase that 
congestion of the brain, which in fatal cases, generally oc- 
curred some hours before death. 
34 



266 DR. RODGERs's REPORT. 

But as far as our observation extended, the remedy that 
had most power, both before and after collapse, was calo- 
mel ; and the other appropriate internal remedies, appeared 
only to play the part of adjuvants to this, which is still pro- 
perly called the Samson of the materia medica. Opiates 
and astringents were very usful in diverting the disease, in 
its incipient stages ; and when the enemy had made greater 
advances, by driving the vital fluid from the outposts of the 
system, they helped to keep this agent of defence in posi- 
tion ; but it was the mighty engine that really battled with 
the foe, and delivered the citadel. In cases where the dis- 
ease was as yet, only regarded as diarrhoea, but in which 
the stools were watery, and beginning to lose their color, 
we gave calomel in half gr. doses, combined with equal 
parts of opium, and sometimes sugar of lead, and where 
there was faintness and sickness of stomach, camphor. We 
preferred the form of pill, and repeated the dose every hour 
or two, according to the urgency of the case ; — at the 
the same time enjoining quiet and warmth. When the dis- 
ease set in violently, we administered the calomel in one or 
two gr. doses, combined with opium, camphor, catechu, 
sugar of lead, &c, as adjuvants, every half hour. This 
treatment was often successful in arresting the diarrhoea, and 
restoring bile to the stools, resulting in speedy recovery. 
After collapse had become complete some cases were restored 
by the persevering administration of this remedy, in fre- 
quently repeated small doses, as a half, to one gr. every fif- 
teen minutes, or larger doses, as v. or x. grs. every hour. — 
We saw a number of such recoveries in Paterson, and heard 
of them in other places. Dr. Brown of Newark, reports an 
example in an adult female. He says, — " when I first saw 
her, the pulse was not to be felt, — the extremities were cold, 
—■the eyes sunk, with a dark circle around them, — features 
shrunk, — frequent copious discharges like rice water, from 
the bowels, and violent cramps of the legs, all indicated a 
case where the powers of life were rapidly deserting the 



DR. RODGERS's REPORT. 267 

outposts, and yielding before the disease. Friction to the 
legs and arms was immediately commenced and actively 
persevered in. Mustard was applied to the region of the 
stomach. Morphia was given, gr. i every half hour. Cal- 
omel, grs. x. every hour, and brandy and ammonia were 
poured down in large quantities almost incessantly. Before 
long the pulse began to be felt, bilious discharges appeared, 
and the patient recovered. Such cases have been sufficient- 
ly numerous to encourage perseverance, even in the stage of 
collapse." 

Dr. Brown says, that in Newark, " Homeopathy failed 
most signally in the treatment of cholera, but the credit of 
cure was sometimes given to the drop of spirit of camphor 
instead of to the full dose of brandy and ammonia, which 
were exhibited at the same time." The same may be said 
of what trials Homeopathy made in Paterson. 

Intermittent and remittent fevers began to prevail early 
in the spring, and continued through the season, till near 
winter. They were in all marshy districts in this vicinity, 
more prevalent and obstinate than usual. The cases of In- 
termittent were especially numerous and obstinate, and 
prostrated the constitution to a greater degree than is usual 
in this part of the country. In some, it induced chronic 
disease of the liver, and repeated hemorrhage, from the nose 
and sometimes from the bowels that proved fatal. In others 
inclined to pulmonary affections, consumption was induced. 
Sometimes as a remedy, arsenic proved more potential than 
quinine, and we frequently used the preparation of Fowler 
in children, without observing any deleterious effect. 

The cases of remittent fever which occurred in the early 
part of the spring, were often complicated with bronchial af- 
fections ; and needed expectorants and counter-irritants, as 
well as febrifuges and alteratives. Bleeding was only occa- 
sionally indicated, and tonics in the latter stages were gener- 
ally required. In the latter part of the spring, and in summer 
and autumn, the complications were also, to some extent of 



2 6 S DR. RODGERs's REPORT. 

a bronchial kind ; but to a much greater extent affections 
of the bowels and liver, — sometimes diarrhoea, in others, dys- 
entery. In districts where the disease was most se- 
vere, in the early stages the head was much affected, and 
delirium and stupor were not uncommon symptoms. These 
cases inclined to the typhoid form. There was an excessive 
dryness of the skin, and absence of blood from its capilla- 
ries. The free use of calomel was not well borne. In some 
cases where it was used but moderately, a dry, grey colored 
ulcer appeared on the inside of the cheek. These cases 
were usually followed by protracted debility, and often by 
an eruption of small boils, which discharged a thin unheal- 
thy pus. 

In the early part of the season we saw one case of re- 
mittent, in an old lady of seventy-five years, which, although 
in other respects mild, was attended at its close with com- 
plete mental derangement, which continued for more than a 
week. 

In the vicinity of the Little Falls of the Passaic River, the 
Intermittent in the character of the onset of the disease, as 
it appeared in the latter part of summer, approached the 
congestive form, described as occurring in the southwest :— 
the coldness and prostration being so extreme, that recove- 
ry seemed difficult. We are not aware that any case proved 
fatal in this stage, but heard of some in which the danger 
appeared imminent. Large doses of quinine were used 
with salutary results. 

Dysentery in a mild form was not an unfrequent disease 
in May and June; but it was in July and August that it was 
most frequent and severe. Cases of it during these months 
were very numerous, and many of them very distressing. 
With the exception of a few localities, the disease was mild, 
and though often protracted in its course, was not often fatal. 
In the town of Paterson a few malignant and fatal cases oc- 
curred, and at the Little Falls, the disease was in most cases 
of a bad type, and often proved fatal. It prevailed chiefly in 



DR. RODGERs's REPORT. 269 

those localities where the intermittent and remittent 
fevers were common, and as the whole system was af- 
fected more or less, we considered it but a form of remittent 
fever. The biliary and digestive organs were implicated 
with the large intestines in the disease. But the discharges 
from the bowels appeared to eliminate the poison from the 
system, so that the fever was sooner cut short than in com- 
mon remittent fever ; and it ceased often, a long time before 
the local affection of the bowels was removed. There was 
often irritating matter in the bowels, consisting of the undi- 
gested remains of food that had been taken into the stomach 
after it had become incapacitated perfectly to perform its 
functions. This, no doubt, often acted as an existing cause 
of the disease, and sometimes determined fever in this par- 
ticular form ; but this could not always be the reason why 
the fever appeared in the form of dysentery: for many sub- 
jects of the disease were those who had been very careful in 
diet, and in keeping the bowels in a good state. Excess of 
caution, in avoiding all articles of an aperient nature, and 
thereby producing costiveness, no doubt was a frequent ex- 
isting cause of the disease, during the past summer. In the 
treatment, the indications, were to clear the bowels by a gen- 
tle purgative, to restore the biliary secretio by calomel, and 
to soothe the irritation and spasm of the intestine and sym- 
pathizing parts, by opium. The first two indications were 
often fulfilled at the same time by viii. or x. grs. of calomel, 
followed by a very gentle dose of castor-oil. After the bow- 
els were once cleared, calomel generally acted best in small 
doses, and after these had been given a few days and some 
bilious matter was passed, small doses of morphia alone with 
gum water and other demulcents had the best effect. Rest 
in the recumbent posture was absolutely necessary, in even 
the mildest cases : and warm poultices to the bowels had a 
good effect. In some few cases where the discharges of 
blood were very large, sugar of lead was given with advan- 
tage : but in the majority of cases astringents appeared to 



270 DR. RODGERS's REPORT. 

add to the irritation, and the anodyne alone could be borne. 
Even ipecac; appeared in many cases to irritate, and was bet- 
ter omitted. 

Diarrhoea was also a common disease, and was in some 
cases very obstinate after the secretios of the liver were in- 
creased by small doses of calomel. We found opium given 
in a carminative fluid mixture with chalk, to succeed far bet- 
ter than when given alone. 

ft During the whole summer, a great many of those who did 
not suffer from cholera, dysentery, or diarrhoea, were affected 
with a tenderness and uncomfortable feeling about the sto- 
mach and bowels. This was the case, not only in the local- 
ities where cholera prevailed, but also in those where it was 
not known. 

Cholera Infantum was less prevalent during the last sum- 
mer, than usual. 

In some localities, the general health was better than com- 
mon, and in those where the cholera prevailed, there were 
fewer deaths during the summer, from other diseases than 
usual. In Newark, for instance, there were sixteen more 
deaths from the usual diseases in the month of July 1848, 
than in July 1849. 

Erysipelas prevailed to some extent in the spring of 1849, 
and some cases have occurred recently. It more frequently at- 
tacked the face than any other part, and was not often very 
severe. As a local application, we have seen as much ben- 
efit from an infusion of opium with sugar of lead, as from 
any other remedy. This gives sensible relief and prevents 
blistering. We keep the part constantly covered with a 
piece of fine linen or muslin, wet with this, at a blood- warm 
temperature. 

We have known of a number of deaths from Hydro- 
cephalus, during the past year. Dr. Craig, of Plainfield, says 
that they have had a number; one of them a child, who reco- 
vered under the use of Hydriodate of Potash. We have se- 
veral times used this remedy in frequently repeated 4 gr. 



DR. RODGERs's REPORT. 271 

closes, without any effect in this disease. We have thus 
given ^ii. of the medicine in the course of a few days, with 
no benefit. What doses Dr. Craig used, he does not inform 
us. 

Some cases of the small-pox were seen among us last 
spring, and a few during the summer ; it began to pre- 
vail epidemically early in the winter, and the cases, both in 
Paterson and Newark, have been very numerous. Most of 
the cases have been of the modified form, but not a few of 
the true disease. The latter, occurred chiefly in those 
who had removed to town from the country, where vacci- 
nation is far more neglected than in the town. The charac- 
ter of the disease, both in the true and modified forms was 
generally mild, many cases requiring little or no treatment. 
We thought we saw good effects, in preventing pitting, by 
keeping the patient in the dark. 

The most troublesome part of the disease was usually the 
affection of the throat. We thought warm poultices to the 
outside gave most relief. 

Almost all of those who were re-vaccinated took the kine 
pox to a greater or less degree. The period in which the 
small pox appeared most certain to affect others was in the 
latter stages of its course, after desquamation had com- 
menced. We observed that one, casually exposed to it in 
this stage was more apt to sicken ten or fourteen days after, 
than one who was exposed at an earlier period. 

Next to small pox, the diseases that have been most pre- 
valent during the past winter and the present spring, have 
been inflammatory affections of the lungs, chiefly of a bron- 
chial kind. Many of these required but little depletion, and 
in their later stages bore tonics. Dr. Brown, of Newark, 
says that during February, "Inflammation of the tonsils and 
bronchia have prevailed, and have in some cases simulated 
pneumonia and phthisis, so much as to render the diagnosis 
difficult without the aid of the physical signs. An apthous 
state of the mouth, and low typhoid fever have sometimes 



272 DR. RODGERS's REPORT. 

attended the cases and called for support to the sinking sys- 
tem." In children we have seen these bronchial affections 
precede affections of the brain, some of the little patients dy- 
ing with all the symptoms of hydrocephalus. 

Hooping cough has also prevailed epidemically for seve- 
ral months past, and in a number of cases induced fatal con- 
vulsions. Ipecac: and Belladon: have proved good remedies . 
We have tried the cochineal in a number of cases, without 
any alkali, and found it effectual. In the latter stage we 
have found small doses of Griffith's mixture to have a happy 
effect. 

Several interesting Obstetric cases have occurred during 
the year. 

We learn that three case of ruptured uterus occurred in 
the month of March. — one in Morris county, of which we 
have not been unable to obtain any particulars; two in New- 
ark, of which Dr. Coles informs us as follows : " During the 
past month two cases of rupture of the uterus occurred in 
this city, and singularly enough, within three or four days of 
each other. The first happened in the practice of Dr. Akers, 
the second in my own. I was called early in the afternoon to 
a woman in labour with, I think, her fourth child. I found 
the os uteri pretty well dilated, but the head higher up than 
usual, so as to require an effort to reach it with my finger. 
In the attempt, the membranes being very tender, were rup- 
tured. The pains were quite regular, and tolerably vigorous 
up to midnight, when finding the head still little inclined to 
descend, and nothing, I thought to contraindicate it, I con- 
cluded to give ergot. I gave in all, I suppose, from half a 
drachm to a drachm, divided into three doses, and adminis- 
tered at intervals until its specific effects were obtained. 
The pains became more powerful and frequent, but were 
not remarkably intense. At three or four o'clock A. M. the 
head had come down, and was lodged in the cavity of the 
pelvis. The pains of labour about this time seemed to go 



DR. RODGERs's REPORT. 273 

off in a great measure — there was sickening at the stomach, 
and vomiting, and complaint was made of a severe griping 
sensation in the epigastric region, or the upper part of the 
abdomen. The abdomen generally was quite tense under 
pressure. I suspected rupture, but as the pulse was scarcely 
any, if at all affected, and there being no recession of the 
child's head, and no hemorrhage, I still hoped I might be 
mistaken. I was met in consultation by Dr. Pennington, 
and he being like myself, not quite positive that there was 
rupture, we waited sometime longer ; but finding there were 
no pains, and no advance of the head, we came to the con- 
clusion to deliver artificially. In attempting to use the for- 
ceps the head was pushed up, when there took place a con- 
siderable discharge of blood from the vagina ; and the head 
now receded so easily as to render it impossible to apply the 
instrument. The nature of the case was now no longer 
doubtful. The limbs of the child, as the head receded, 
passed through the rent in the uterus, and could be distinctly 
felt through the parietes of the abdomen. Failing with the 
forceps, the hand was introduced and the feet seized and 
brought down without material difficulty. But the delivery 
of the head required the use of the crotchet, it being large 
and the bones firm. The patient was very faint and feeble 
after the delivery, so as to make a free use of stimulants 
necessary. Anodynes were given, and effervescent draughts 
to allay vomiting, which still continued. The abdomen 
was greatly distended and quite tender. She died on the 
third day. A post-mortem examination was not allowed. 
Dr. Akers' case, I understand was very similar to mine ; 
the woman died about the third day. In this case, how- 
ever, no ergot was given, and the labor was neither se- 
vere nor tedious. 

********* 

There have occurred during the past year, in Paterson 

and vicinity a considerable number of cases of puerperal 

convulsions. The most of them last spring, and in the early 
35 



274 DR. RODGERS's REPORT. 

part of the summer. We think the number of cases greater 
than the whole number that had occurred in this vicinity 
for six or eight years before. In some of these the convul- 
sions appeared before, and in some soon after delivery. In 
some of the cases the labor was severe, and in others quite 
as easy as usual. The majority of the cases were first labors 
and most of the patients rather young. In some of the pa- 
tients there were premonitory symptoms, such as pain 
in the head, great irritability, &c. In others, the convulsions 
suddenly appeared when entirely unexpected. Most of 
the patients recovered after one free bleeding, purgative 
doses of calomel followed by castor oil, spirits turpentine, 
and the steady use of cold to the head. A number of cases 
of puerperal mania have also occurred in Paterson and have 
proved fatal. 

Dysentery, unless of the mildest kind, was more often fa- 
tal, than otherwise, when it appeared soon after parturition. 

A case of retention of urine of some interest occurred to 
Dr. John Magee, of Paterson. There appeared to be per- 
manent stricture, and also spasms. The pain and distress of 
the patient was very great. After several persevering and 
careful, but ineffectual efforts to introduce the catheter, large 
and repeated doses of morphia were given, and after some 
hours the patient was enabled to pass water. The ano- 
dynes, and with them warm fomentations were continued, 
and thereby the difficulty removed. 

Dr. Coles, of Newark, has communicated to us the follow- 
ing case of Traumatic Aneurism. 

Michael Mellon, a fireman of this city, received a stab in 
the right ear, probably with a knife, making a wound about 
three-quarters of an inch wide. It passed in behind the ramus 
of the lower jaw, close to the articulation, and so through 
into the back part of the mouth, transfixing the tonsil 
The facial nerve, (the portio dura of the seventh pair,) was 
partially wounded where it passed through the parotid gland, 
thus giving rise to considerable distortion of that side of the 



DR. EODGERS'S REPORT. 275 

face. The hemorrhage was considerable at first but soon 
ceased, returning however, at intervals during the first two 
or three days, both from the ear and the throat. At the end 
of a week or thereabouts, the attending physicians, Drs. Akers 
and Smith, of this city, discovered a pulsating tumour just 
in advance of the ear, in the situation of the parotid gland, 
which they decided to be aneurism, consequent upon a 
wound of an artery, most likely either of the internal or ex- 
ternal carotid. There was a consultation of physicians, my- 
self of the number, and it was agreed to attempt the cure by 
continued pressure over the common carotid. The tumour 
was quite large and strongly pulsating. Some part of the 
swelling, it was supposed, was owing to concomitant inflam- 
mation of the wounded parotid, as there was ptyalism 
and an odour of the breath, like that denominated mercurial. 
In addition to compression of the artery, ice and evapo- 
rating lotions were applied to the tumour. They were per- 
se veringly used and carried to as great an extent as was 
deemed prudent : also the internal use of sugar of lead in 
combination or alternation with digitalis. At the end of 
seven or eight days after commencing the use of these 
means, all pulsation ceased in the tumour for the space of 
twelve hours or more, which inspired a hope that they 
would prove successful ; but the pulsation returning, and 
the tumour proceeding to enlarge, and to show signs of 
pointing, its walls seeming to grow thinner, it was consider- 
ed unsafe to defer an operation longer. Accordingly, on 
the 11th of May 1849, and something less than three weeks 
from the appearance of the aneurism, and four weeks from 
the infliction of the injury, I performed the operation of ty- 
ing the common carotid, — most of the Physicians in the city 
being present. The pulsation in the tumour immediately 
ceased, but there was a slight return some few hours after- 
wards, when the recurrent circulation became established, 
but soon disappeared again totally and finally. The tumour 
next day began evidently to decline, and the general condi- 



276 DR. DUNNES REPORT. 

tion of the patient was comfortable. The favourable symp- 
toms continued until the third or fourth day, when there 
suddenly supervened a convulsive action of the muscles of 
the opposite side, particularly those of the arm, which was 
soon ascertained to be paralytic. A loss of sensibility was 
found likewise to have taken place over one half of the 
trunk, but did not extend to the leg, which retained partial- 
ly, both the power of sensation and motion. Notwithstand- 
ing these portentous symptoms, which are so generally the 
forerunners of a fatal termination, he happily survived, and 
is now, eleven months after the operation, in the enjoyment 
of good health, although the side that was paralytic is not 
altogether as strong as before. One peculiarity, which I 
omitted to notice, was a remarkable slowness of the pulse, 
both before and after the operation. As this occurred at the 
time we were using the digitalis, it was at first ascribed to 
that, but inasmuch as it persisted after the discontinuance of 
that drug, and was disproportioned to what might be expect- 
ed from the quantity given, we were subsequently disposed 
to attribute it to some other cause operating on the great 
nervous centres. Before the operation, the pulse was much 
of the time not over fifty-five or sixty, and after the opera- 
tion it sunk down to forty beats, and even lower. Some of 
the patients friends think that his mind is less vigorous than 
it was prior to the injury. 



REPORT FROM THE MIDDLE DISTRICT. 

BY J. J. DUNN, M. D. 

As reporter from the middle district, I give you an outline 
of the diseases that have prevailed most extensively during 
the past year. 

The cholera made its appearance during the summer, and 
presented the usual symptoms. There were not many 
deaths in our district, (from twenty to thirty as far as I have 



dr. dtjnn's report, 277 

been able to ascertain.) The proportion of deaths to those 
attacked, was nearly one to three. Where medical aid was 
called, before collapse had taken place, the disease was 
mostly manageable: — recovery from real collapse was not at 
all frequent. The treatment pursued by the different prac- 
titioners was always with a view to exciting the surface, 
relieving spasms, checking the free discharges from the bow- 
els, and exciting the liver. Mustard, frictions, artificial 
warmth, opium, camphor, chloroform, catechu, sugar of 
lead, and calomel were resorted to. 

There was some dysentery following the cholera in the 
fall. It was not of a malignant character, and offered no- 
thing unusual in symptoms or treatment. 

Fevers of all types, have been less frequent in our district, 
during the past year, than ordinary. The low form that 
has so often visited Princeton, has been scarcely known. 

Neuralgic complaints and rheumatism have prevailed to 
some extent, but not to any remarkable degree. Your re- 
porter has no extraordinary cases to notice. As it was at the 
period of the first appearance of cholera — all diseased action 
seemed in a measure, directed to the alimentary canal, and 
suspended for a season, other derangements of the body. 

Amongst the remedies recently introduced to the profes- 
sion, Cod Liver Oil takes a prominent place. Its great value 
in some forms of disease, is now understood. Almost every 
practitioner who has had opportunities to witness its effects, 
speaks of remarkable cures. This fact being so certainly 
established, the profession is now engaged in accounting for 
its mode of operation by the aid chemistry gives as to its 
composition, and the character of the diseases it is active in 
removing. 

On the advantage of chloroform, little has been said dur- 
ing the past year in our district, except as a remedy in cho- 
lera. Surgical operations of a painful nature have been per- 
formed without resorting to it. In view of the disa- 
greeable results that have followed its exhibition in some 



278 REPORT OF STANDING COMMITTEE. 

cases, patients generally would rather bear pain, than run 
the risk of some nervous disaster. Our dentists have al- 
most entirely abandoned it in their operations. 



SUMMARY OF REPORT OF STANDING COMMITTEE. 

The standing committee in presenting their report, are glad 
to have the opportunity of laying before the society, the able 
reports from the different districts. The diseases that have 
been prevalent during the year, are well described, and the 
most satisfactory modes of treatment have been made known. 
Cases of interest have been recorded, and all subjects of 
practical importance have, as far as possible, been brought 
before the society. 

As a committee to advance the interest of medical science, 
we would suggest the propriety of the state society consider- 
ing the practical observations of the various members scat- 
tered over the State, as the data for deeper research than the 
engagements of the reporters have enabled them to attempt. 
We would regard it a step towards important ends, if on the 
different prominent diseases that are so often described, 
committees were appointed to investigate, and make known 
the results of their labors. Pathological anatomy, and vital 
chemistry at this time, are so much relied upon for the expla- 
nation of disease, that any course which does not enlist their 
aid, seems behind the knowledge of the day, and unworthy of 
the profession. We have amongst us competent men, who 
would willingly engage in such research under sanction of 
the society. They would hand in their results at regular 
times, and these, in many instances, would be a valuable ac- 
quisition to medical men. For accurate observation, no 
practitioner enjoys better opportunities than a country phy- 
sician. With nothing to divert his mind from his case, as he 
rides from one patient to another, he gives it a degree of 



REPORT OF STANDING COMMITTEE. 279 

thought that would be impossible in the bustle of a town. — 
Alone in his observations, seldom overruled by another of 
more age and celebrity in his profession, he observes with 
an accuracy almost instinctive. He sees things as they ex- 
ist, and from the facts reported by these men, accumulating 
from year to year, the most important theories could be es- 
tablished or disproved. 

In another view, such a course would be profitable ; it 
would show to the community that as a body, we are en- 
gaged in the advancement of medical science ; not practicing 
merely for pecuniary compensation. It would remove us 
from the injurious contrast with the various pretenders to 
medicine, and make plain the wisdom of Legislative protec- 
tion. To recount symptoms, and administer remedies, sci- 
entifically, is, to the well-informed medical man, a pleasing 
illustration of the learning and skill of the practitioner ; but 
the same, to the uninformed, is no more than he witnesses 
from illiterate doctors, and as far as he knows, with equal 
reason and effect. Something more must be done, we re- 
spectfully submit, to raise our profession above the rivalry 
of every set of charlatans who make incursions into our 
state ; something, to which legislators can refer as our work, 
with an understanding of its real value. There are diseases 
in which all are deeply interested, some on which the com- 
munity is fearfully agitated. If it were known that on these 
subjects our most competent professional men were engaged 
under direction of the society, and that they were required 
to make reports from time to time, to such alone would the 
public look for information and advice. Had such a course 
been pursued for years past, the New Jersey Medical Soci- 
ety could point to an accumulated mass of medical research 
of inestimable value. 

The great characteristics of medical treatment, as now 
pursued by the most enlightened physicians, are a close 
scrutiny into the organic functions, and vital chemistry, 
a due consideration of the unaided restorative powers of 



280 REPORT OF STANDING COMMITTEE, 

the system, and less reliance upon the free use of remedies * 
— less medicine is given, and more thought bestowed upon 
the influences that cause diseased action, and prevent a res- 
toration to health. Accurate researches have been made 
into the animal organism, and the laws that control their 
functions — medication, as a consequence, is becoming*less 
experimental, and a treatment for diseased action is now 
adopted, that has some reference to the nature of the ele- 
ments that are to be supplied, the affinities that are to be 
broken up, and precise function to be controlled. It is this, 
in reality, that makes medicine a science, and removes 
from it the odium of quackery. Your committee feel the im- 
portance of this change in medical practice becoming gene- 
ral, and think that every educated physician should apply the 
science and reason which he is supposed to possess, in further- 
ance of this object. We would also recommend every physi- 
cian to be, as far as his ability will serve, a medical teacher. 
One reason why quacks gain a place amongst us is, the neglect 
on the part of regular physicians, of making plain, as far as 
may be, the reasons which guide them in their practice. With 
truth and nature on his side, the physician can certainly, if fit 
for his profession, oppose successfully falsehood and nonsense. 
He can, dropping the solemn air, and oracular words of the 
wig and cane, make himself an agreeable instructor as far as 
the education and capability of his patient will comprehend 
his teaching. He can certainly foil his adversary, except in 
those doctor loving and troublesome idiocyncracies, in which 
disease is cultivated as an accomplishment, and supernatu- 
ral twaddle is required of the medical attendant. We would 
recommend the greatest openness of communication. Medi- 
cine is no longer a mystery, books are at hand, all can 
read, and many expect from the physician more than the 
service of the mere apothecary. 

Our county societies have valuable addresses delivered be- 
fore them on general medical subjects, though no society that 
we are aware of, has instituted any kind of research on any 



r.nruilT OF STANDING COMMITTEE. 281 

proposed subject, and required the results to be made 
known. The Mercer county society requires every mem- 
ber to come always prepared with a written article on some- 
thing relating to his profession, so that if called upon, there 
shall be no failure on the part of any individual. They meet 
quarterly. A number of papers have been read, some of 
them important — one by Dr. Paul at their last meeting, on 
the inorganic constituents of the food of children as connect- 
ed with the decay of the teeth, and the physical constitution 
of the women of America, was a carefully considered, well 
arranged, and most valuable paper. The object of the au- 
thor of this essay, which is in the form of an address to pa- 
rents, (with a view to publication) is to examine into the 
causes of so great a calamity ; which in his opinion, is 
mainly attributable to the deficiency of the earthy constitu- 
ents in the food of children, particularly in the article of 
lime. In elucidation of this subject, he enters into the struc- 
ture and conformation of the teeth, the blood, and the 
food. He shows that these constituents are held in the milk 
of the mother — the true food of infants. But during child- 
hood, much of the inorganic constituents contained in wheat 
is taken away in separating the bran, and reducing it into 
superfine flour, while there is scarcely a trace of lime in corn, 
even if not deprived of its bran when rendered into meal ; 
and these two articles, in various forms, constituting a 
great proportion of the food of children, they are deprived 
of much of their earthy constituents at a period when mostly, 
and absolutely required. The whole is interspersed with 
observations, and chemical analyses of the different struc- 
tures, fluids, and other combinations touched upon. 

Essays such as this, requiring science, practical observa- 
tion, and labor, are productive of the greatest benefits. The 
information imparted, is so much added to our stock of 
knowledge, and it excites a spirit of emulation in the pro- 
fession, which is the great end of our society organizations. 

Your committee will not attempt to swell these reports to 
36 



282 REPORT ON PRELIMINARY EDUCATION. 

an undue extent, by referring to any diseases of the past 
year — remedies, or improvements in practice. The district 
reporters have given them a notice as extended as the 
limited time of the society will allow. 

With regard to irregular practitioners, the usual complaint 
must be made. There are, in every county, as far as we 
can learn, men practicing medicine, who are not entitled to 
an examination, and others having the requisite qualifica- 
tion who refuse to come before the examiners. 

We have heard of no violations of the medical law in any 
of the county organizations, nor of any new matter to which 
the attention of the standing committee has been particular- 
ly directed. 

James B. Coleman, 

Chairman of Standing Committee. 



REPORT ON PRELIMINARY EDUCATION. 

Read before the Distinct Medical Society of Gloucester 
County. By Joseph Fithian, M. D. Chairman of 
Committee on that subject. 

The committee appointed at the last semi-annual meeting 
of the Gloucester County District Medical Society, to take 
into consideration the subject of the preliminary education 
of candidates for the medical profession — 

Report, That after due deliberation they believe the time 
has come, when a higher standard should be required of the 
candidates for the medical degree, than has been the custom 
heretofore to demand, or than perhaps the circumstances of 
the country in times past would warrant. 

It has been but a few years, since medical schools were 
first instituted in this country, to teach medicine by public 
lectures ; previous to that time, the medical student had to 
obtain all his medical information in the office of his precep- 
tor, and a comparatively low standard, both of classical and 
medical knowledge was at that time to be obtained; the 
exceptions to this state of things were few ; young gentlemen 



REPORT ON PRELIMINARY EDUCATION. 283 

of fortune, those who were able to bear the expenses neces- 
sary to a more thorough acquaintance with medical science 
and literature, went abroad for that purpose, and visited the 
celebrated schools of Europe — and upon their return, were 
looked upon with great respect for their high attainments, 
and more elevated position. This was the case, till the Uni- 
versity of Pennsylvania was organized into a medical school; 
and persons are now living, who can remember when Mor- 
gan and Kuhn — Shippen and Rush, the first professors of 
that institution were appointed to those offices. Since that 
day, the science of medicine has made rapid strides in its ad- 
vancement towards perfection : — now, we are enabled to 
give the candidates for the degree of doctor of medicine, as 
good an opportunity for acquiring medical knowledge as he 
could have abroad. 

With the advance of the means and facilities for know- 
ledge in medicine, has general education also been advanced 
and perfected? Then, high schools and academies, where all 
the branches of a liberal education were taught, were few 
and far between, and colleges and universities were still 
fewer in proportion : of course the difficulties in the way of 
the medical student for obtaining a good and thorough pre- 
liminary education, were much greater than at present. — 
Now, the country is studded with its high schools and aca- 
demies, where the higher branches of a good English edu- 
cation may be obtained, with a respectable knowledge of 
mathematics, natural history, natural, mental, and moral phi- 
losophy, and the classics. Then, the times of ignorance were 
winked at — now, we are called upon to repent. There is, 
therefore, at present no excuse if the candidate is not well- 
informed upon all these subjects, and he should be required, 
before he is permitted to enter the office of a preceptor to 
study the science of medicine, to give suitable testimonials 
that such is the case. 

The science of medicine may be said to be the science of 
all nature, there is no limit to its demand upon every other 



284 REPORT ON PRELIMINARY EDUCATION. 

branch of learning, for the proper elucidation of its principles, 
and their scientific application to the art of curing disease. 
The physician has not to do with mere dead, inert matter, 
but life, vitality — that something which is superadded to mat- 
ter ; he has constantly to study life in all its various phases, 
from the plant which vegetates, grows, lives, — to man, the 
highest specimen of living, animated nature. 

It may then be gravely asked, who is sufficient for these 
things ? Certainly not the ignorant, the uneducated ; but he 
(everything else being equal,) who has the most extensive 
knowledge of nature's laws and nature's operations ; or in 
the language of modern philosophy, of objective and subjec- 
tive science. 

There are other reasons, why the student of medicine 
should be a well educated man, in other branches, and upon 
other subjects than his profession alone. The more general 
diffusion of learning among all classes requires, that if the 
physician would sustain himself in the rank of learning and 
respectability, which he has heretofore enjoyed, he must 
keep pace with the discoveries in science, and general litera- 
ture abroad ; or the prestige of doctor, teacher, learned, 
which has been associated with the name, will no longer at- 
tach to him or his profession. 

There is, therefore, a reason why the preliminary studies 
of the candidate should be thorough, if he would sustain the 
respectable rank of a learned man in his profession. 

He will have too, to meet the army of quacks and pre- 
tenders who prey upon the credulous public, and be able to 
expose their sophistry and cunning, both by his learning 
and skill : formerly, quacks and mountebanks were confined 
to the rude and ignorant; now, men of education and stand- 
ing enter the lists, that they may prey upon the community, 
more successfully, depreciating and misrepresenting the re- 
gular practitioner, and by all manner of devices, openly and 
covertly, seek to advance their own schemes for cheating 
the public at his expense. Thence has arisen such an army 



REPORT ON PRELIMINARY EDUCATION. 285 

of pretenders to the healing art, under the names of Thomp- 
sonianism, Hemceopathy, Hydropathy, Analytic medicine, et 
id omne genus, and the sophistry, learning, skill and cunning, 
which they bring to their aid is worthy of a better cause. 

Another reason, why we should check the propensity to 
enter the profession unprepared, by a thorough preliminary 
education, is the large number who enter its ranks from 
every quarter, till the supply has more than kept pace with 
the demand. Medical colleges have increased to such an 
extent, that figuratively speaking, one has become a thou- 
sand, and the whole country is flooded with doctors. Not a 
city, village, or neighborhood is to be found, that is not over- 
stocked by the profession. The estimate made by the com- 
mittee of the American Medical Association, in their report 
upon medical education is, that to relieve the diseases of 
something more than twenty millions of people, we have an 
army of doctors amounting by a recent computation to forty 
thousand, which allows one to every five hundred inhabi- 
tants, and if we add to this number the long list of irregular 
practitioners, who swarm like locusts in every part of the 
country, the proportion of patients will be still more reduced. 
" No wonder then, (they say) that the profession of medi- 
cine, has ceased to occupy the elevated position, that once it 
did, no wonder that the merest pittance, in the way of re- 
muneration, is scantily doled out to the most industrious of 
our ranks." Again, " the position can scarcely be contro- 
verted, that a proper inquiry into the fitness of young men, 
to become students of medicine, is but seldom instituted, and 
numbers have been admitted into the office of their precep- 
tors who were deficient, even in the most common branches 
of an English education. Too long has it been imagined, and 
too often has it been asserted, that the veriest dolts possessed 
intellect for the study of medicine. To such, the idea never 
could have occurred, that within its broad and expanded 
limits, may profitably be included a knowledge of almost 
every science ; nay more, may we not truly say, that a high 



2S6 REPORT ON PRELIMINARY EDUCATION. 

and exalted position can never be attained, unless the mind 
be well stored with an amount of collateral information, 
which will be found to bear upon our professional studies at 
every step." 

The fact is, that in times past, there has been no standard 
to which the candidate has been required to conform : this 
has been left to himself, or to the physician into whose office 
he might wish to enter. The consequence has been, that many 
have not only been received, but we fear encouraged, to en- 
ter upon the study of medicine, who appeared to possess no 
other qualification or recommendation, but that they wished 
to be a doctor, or that they happened to have the means to 
pay the expenses of their medical education ; while these 
are a necessary part of the qualifications of a candidate, they 
certainly are not all that should be required of him. 

For these, with other reasons of a practical nature, we 
come to the conclusion, that there should be a standard, — a 
rule to which all should be required to conform, who would 
enter upon the study of medicine. It was to accomplish this 
purpose among others, that the American Medical Associa- 
tion was called into existence. The times demanded it; one 
of the first things the Association did at their first meet- 
ing in 1846, was, to appoint a committee upon this sub- 
ject, to report in 1847. This report is before the country, 
and a response has been made, favorable to the subject, 
wherever an opportunity has occurred. 

The New Jersey State Medical Society, in May last, the 
New York State Medical Society, in February, and the 
Pennsylvania State Medical Society, at their meeting a few 
days since, in the city of Philadelphia, have urged the mat- 
ter to the favorable consideration of the profession. The ball 
has been set rolling, and it will not be arrested till the mat- 
ter shall be accomplished. 

What then, we would inquire, should be the rule ? 

What amount of preparatory education, shall the profes- 
sion demand of the candidate? While we would not de- 



REPORT ON PRELIMINARY EDUCATION. 287 

mand, that the standard should be placed too high, we would 
have a rule, sufficiently modified, to which all should con- 
form, and below which, none should be received. Let this 
rule be zero. If the student can rise in the scale to the high- 
est degree of knowledge, so much the better. While we are 
not prepared at present, to demand that the candidate should 
be a graduate of a college or university, in every case, or 
thoroughly read in the literature of the age ; however desir- 
able this may be, we make it obligatory, that he should have 
what is termed, a liberal education, — or, in other words, that 
he should have made himself acquainted with the scientific 
and classical literature, ordinarily taught in our high schools 
and academies. This would not exclude any one of ordina- 
ry fair talents, nor increase the expenses to such an extent, 
as to prevent those of industrious habits, and moderate 
means, from entering the profession, and would at the same 
time, guard it from the ignorance, that has too often been 
graduated into its ranks. In fact, "they must honor their 
profession, or the profession will not honor them." 

The regulations of our Medical Universities, scarcely take 
cognizance of the amount of preparatory education of the 
graduate. Harvard University requires the most of its can- 
didates for the medical degree: in addition to the ordinary 
branches, he must be able to read Cicero in the original. 

The University of Pennsylvania requires, that the candi- 
dates shall write a thesis upon some medical subject, that the 
essay shall be in his own hand writing, and that general bad 
spelling in a thesis, or general inattention to the rules of 
grammar, will preclude a candidate. This is certainly a 
standard low enough, for the most radical, and still we fear, 
that if some of the candidates were rigidly examined, even 
upon these qualifications, they would be found wanting. 

H. L. Heiskill, acting surgeon of the U. States Army, says, 
in a communication to the committee of the American Med- 
ical Association on medical education, " that one of the 
most striking causes of failure on the part of candidates, (for 



288 REPORT ON PRELIMINARY EDUCATION, 

the army service,) is the insufficiency of preparatory educa- 
tion ;" and may we not say, that the same reason operates 
to a still greater extent, to deteriorate and lower the standard 
of respectability of the profession at large ? 

The European Universities require a much higher stan- 
dard of the candidate, than we have even thought of. Who- 
ever will read the report above referred to, on this subject, 
will perceive, the thorough knowledge he must possess of 
language, science and literature, before he can be admitted 
into the profession. 

Their theses must be written, and defended in the Latin 
language, and they require, that the student shall write off' 
an essay upon some subject selected on the spot, in a room 
shut up by himself, without books or other assistance, and 
in a foreign tongue, and defend it in the same language; and 
their examinations are extended to days and weeks. 

It may not be inappropriate here, to refer to the custom of 
many of our respectable religious denominations, with re- 
spect to the education of their candidates in theology. 

In addition to their profession of a divine call to the min- 
istry, and before they can receive a license, to exercise their 
office, they must have graduated in some respectable college 
or university, or receive the same amount of learning from 
some other source. That they may satisfy themselves upon 
this point, in addition to their examination on theological li- 
terature, they are from time to time, thoroughly examined, 
upon their scientific and classic attainments,-the consequence 
is, that they are a thoroughly educated profession, and there- 
by, enabled to wield a much more extensive influence. 

But to return to the question — what shall be the standard 
of preliminary education required of the medical candidate ? 
That he should be liberally educated, or in other words pos- 
sess himself of the elements at least, of those branches, 
which enter into such an education, as before explained, 
there can be no doubt. This is requisite for two reasons — 
first, it is only in this way, he can get the habit of study ne- 



REPORT ON PRELIMINARY EDUCATION. 289 

ecssary to the student of medicine, or in other words "learn 
to learn" — second, the information thus obtained, is neces- 
sary in the further prosecution of this science, and to enable 
him to comprehend the subject. 

The knowlege of the Latin and Greek languages is high- 
ly important for many reasons; one only will we here name, 
and that is, that the candidate may be enabled to understand 
the terms of his profession, and decipher the directions of a 
prescription ; this may be all that is absolutely requisite ; less 
than this cannot be dispensed with. A knowledge of the 
mathematics, it is unnecessary to say, is still more important, 
and cannot be neglected. They are necessary even to the 
common and every day business of life ; how much more to 
the professional man, as a means of disciplining the mind to 
close study and exact thought. 

Natural history, including zoology and botany, enter into 
the whole course of the study of the medical man. With- 
out the knowledge to some extent of botany, how is the 
student to become thoroughly acquainted with materia me- 
dica, and if he shall be ignorant of zoology, how shall he 
study comparative anatomy, so necessary to comprehend 
the proper functions and structure of the human system. — 
" The physician, (says Prof. Ware,) is a student and interpre- 
ter of nature, and of every thing relating to life; whether in 
health or disease, he must study it as a whole, to compre- 
hend its parts; and he should study natural history as a part 
of the' great science of living things." 

Natural philosophy is also a branch of study which should 
engage his attention. How can he explain the laws of ani- 
mal motions if he does not understand those of mechanical 
motions, or 'how meet the demands of a dislocation or 
fracture for peculiar treatment, without the principles of 
physics? Again, the laws of the pressure of the atmosphere 
in respiration, and of hydrostatics, in the circulation of the 
fluids, are indispensable. In fact the principles of this sci- 
ence are demanded at every step in our profession. 
37 



290 REPORT ON PRELIMINARY EDUCATION. 

The knowledge of mental philosophy is necessary to com- 
prehend the science of mind, he should have a thorough ac- 
quaintance with its faculties and healthy operations, that he 
may more successfully study it when diseased, and thus be 
enabled to overcome its terrible maladies. 

Reasons equally urgent demand that he should be familiar 
with the principles of moral philosophy. 

"The student of medicine, (says the author above referred 
to,) should also acquaint himself to some extent, with gene- 
ral literature and polite learning. A mere knowledge of 
medical science, or of any science, will not make him an ac- 
complished man ; if he would command the respect of men 
generally, or even of his own profession, he must show that 
he is able to rise above the mere routine of his profession. — 
Nothing tends more to liberalize, refine, and embellish the 
mind than habitual recourse to the treasures of English 
literature, the richest inheritance after the spirit of free in- 
stitutions, that we have received from our ancestors." 

We might enlarge upon this subject, but enough we think 
has been hinted at, to urge upon us the necessity of unit- 
ing with the profession generally, in bringing about reform, 
and so promote as far as in us lies, the efforts to elevate the 
standard of medical education, and at the same time, to ad- 
vance the respectability of medical men every where. 

Joseph Fithian. 
Chairman of Committee. 

Resolved, That it is expedient to adopt a uniform system 
of preliminary education, for candidates for the study of me- 
dicine, in the State of New Jersey. 

Resolved, That the following amendments be made to the 
by-laws, in chapter seventh, section fifth, sub-section second, 
sixth line, after the word " years," and previous to entering 
on his medical studies he did file with his medical preceptor 
a diploma from some college, or a certificate from some re- 
spectable High-school or Academy, (a copy of which shall 



REPORT OF COMMITTEE ON CHARTER, 291 

be presented to the board of censors, at the time of his exa- 
mination,) that he has a respectable knowledge of at least the 
following branches of science, viz: mathematics, natural 
history, including zoology and botany, natural, mental, and 
moral philosophy, the classics and belles-letters. 



REPORT OF COMMITTEE ON CHARTER AND BY-LAWS. 
BY S. H. PENNINGTON, M. D. CHAIRMAN. 

The Committee appointed at the last annual meeting of 
the medical society of New Jersey, to revise the charter and 
By-Laws of the society, respectfully report, 

That, though entertaining doubts, in common with other 
members of the society, of the expediency of applying to the 
legislature of the State for any alterations of its medical 
laws, yet, considering the resolution under which they were 
appointed, as indicating a readiness on the part of the soci- 
ety to make such application, they have felt it their duty to 
suggest some changes in the charter, which experience has, in 
their opinion, proved to be desirable, and such amendments 
of the By-Laws as will make them conform to the proposed 
changes in the charter. 

The committee have not deemed it necessary to prepare, 
in form, an amended charter, supposing that, if on mature 
consideration it is thought desirable to prosecute the subject 
before the legislature, it would be the wish of the society 
that some person familiar with legal forms and requirements 
should be consulted for that purpose. They have thought, 
therefore, that they would be discharging their duty by sim- 
ply pointing out the changes they have to propose, and re- 
commending that, if the society concur in their suggestions 
and resolve to adopt them, a committee be charged with the 
preparation of a proper bill, and invested with authority to 
employ such legal aid as they may deem necessary. 



292 REPORT OF COMMITTEE ON CHARTER. 

Section \,page 4 of the society's printed copy of the law. 
— The committee propose that the first section of the charter 
be so amended, as to provide for an annual meeting of the 
medical society of New Jersey, at Trenton, during the sit- 
ting of the legislature, viz: on the fourth Tuesday of Janu-_ 
ary, and to dispense with the semi-annual meeting. 

Sec. 2, page 7. — They propose to alter the second section 
of he charter by substituting the words, "its next annual 
meeting," for the words "any anniversary meeting ;" to de- 
note the time when newly formed district societies shall pre- 
sent a copy of the proceedings had at their first meetings. 

Sec. 8, page 10. — In order that the provisions of the char- 
ter may more strictly conform to the present practice of the 
society, the committee propose that the eighth section be sd 
amended, as to provide for the appointment of a board of 
censors of the medical society of New Jersey, consisting of 
four members from and for each of the district medical so- 
cieties, legally organized within the state. 

Sec. S,page 11. — To invest the society with power to 
secure a proper amount of preliminary education in candi- 
dates for license, the committee propose, in the eighth section, 
to add to the enumerated subjects of examination, the follow- 
ing, "and such branches of general science and learning, 
as the medical society of New Jersey may designate." 

Sec. 9, page 12. — The more fully to carry out the object 
of the last amendment, the committee propose to amend the 
ninth section, by adding after the words "the term of four 
years" the following, "one of which shall have been employ- 
ed in the study of such branches of general science and 
learning, as shall have been designated by the medical so- 
ciety of New Jersey, agreeably to the provisions of the 
eighth section of this act." 

Sec. 10, pages 12 and 13. — The committee propose that 
the tenth section be repealed as unnecessary and burthen- 
some to the candidate, without affording additional security 
to the society. 



REPORT QF COM Mil' IKE ON CHARTER. 29?> 

Sec. \\,page 14. — The eleventh section, to he enumerated 
as the tenth, it is proposed to amend so as to require candi- 
dates for a license, to apply to the medical society of New 
Jersey, through some one of its boards of censors, for the 
district societies, instead of directly to the state society. 

Sec. \2 y page 15. — The twelfth section, to he enumerated 
as the eleventh, the committee propose to amend by striking 
out the penal clause against regularly educated physicians, 
practising without license; but inasmuch as it can be deemed 
no hardship to withdraw the protection of the law from 
those who refuse to comply with its requirements, they pro- 
pose to retain the disqualification in regard to the collection 
of bills for medical services. 

Sec. 13, page 16. — The thirteenth section, to be enumerat- 
ed as the twelfth, it is proposed to amend, by substituting 
the disqualification named in the preceding section, in the 
place of the penal clause. 

New Section. — The committee propose to introduce here 
a new section, to be called the thirteenth, providing on ap- 
plication of a district society, and satisfactory evidence for 
the revocation of license by the medical society of New 
Jersey, from persons who have obtained it fraudulently, or 
who have dishonored themselves by disgraceful conduct, or 
by gross mal-practice. 

Sec. 14, page 17. — The fourteenth section, the committee 
propose to amend, so that all persons, who shall commence 
practice or surgery, within this state without license from 
this society, and without a diploma from some medical col- 
lege or university, recognized by the medical society of New 
Jersey, as well as all irregularly bred pretenders to the heal- 
ing art, as defined in this section, beside being subjected to 
the disqualification specified in the twelfth section, shall for- 
feit and pay the penalty therein declared against unlicensed 
practitioners. It is further proposed to amend this section, 
by making it the duty of the overseer of the poor, when re- 



294 REPORT OP COMMITTEE ON CHARTER. 

quested so to do by the district medical society of the coun- 
ty, or by any citizen of ihe township, to prosecute the of- 
ender. 

An Abstract of the Proposed Amendments of By-Laws. 

CHAPTER i. 

Section 2. Change time and place of annual meeting to 
"fourth Tuesday in January, at Trenton" omit the pro- 
vision for a semi-annual meeting, and make the quorum to 
consist of delegates from four district societies, instead of two. 

Sec. 4. Omit orders of business, for semi-annual meet- 
ings, introduce an order for the appointment of a commit- 
tee to nominate officers, and one for an essay on some me- 
dical or philosophical subject. 

Sec. 5. Repeal. 

Sec. 6. Provides for special meetings , and makes the 
quorum the same as at annual meetings. 

CHAPTER II. 

Sec. 4. Repeal. 

Sec. 8. Provides for a reporter from each district soci- 
ety, and requires him to report to the standing committee 
on or before the first dayy of January, annually. 

CHAPTER III. 

Sec. 3. Substitute "January" for "May." 
Sec. 7. Repeal. 

CHAPTER IV. 

Sec. 6. Requires nominations for the honorary degree of 
M. D., to be made by a majority of the whole number of 
Fellows, and all the Fellows present, and three fourths of the 
members to concur in the nomination. 



REPORT OF COMMITTEE ON CHARTER. 295 

Proposed Form of Diploma for the Degree of M. D. t when 
conferred on examination. 

SOCIETAS MEDiCA, 

RESPUBLICA NEO CcESARIENSIS, L.EGIBUS rONSTITTl A, OMNIBUS HAS 

LITERAS LECTURIS, SaLFTEM. 

Quoniam A. B. vir ornatus et moribus inculpatus; qui 
omnibus studiis ad medicincE et chimrgioe usum scientiam- 
que spectantibus animum fideliter intendit, et, arte medendi 
septem antios se tetitavit, opinionibus hominum faventibns, 
nobis commendatus est ut ad gradum Doctoris Medicines 
Chirurgiaeque proveheretur : 

Notum Sit quod placet nobis, auctoritate hacce societata, 
collata, inquisitione ejus periticB diligentissirna coram vins 
selectis et eruditis, secundum leges Neo Caesariensis et hu- 
jusce societatis, imprimis habita, supradictum A. B. titulo 
graduque medicinoe et chirurgice Doctoris adornare, eique 
omnia jura, privilegia et honores ad istum gradum pertinen- 
tia, dedere et concedere. 

Cujus rei, hocce Diploma sigillo societatis nostrae, Prcesi- 
disque Sociorum et Scriboe chirographis ratum, testimonium 
sit. 

Datum Trentonice, die ante 

Kalendas Februarii, Anno Domini millesimo Octingentesi- 
mo et Societatis. 

Pragses. 
[L. S.] Scriba. Socii, 

CHAPTER V. 

Sec. 2. Erase to the semicolon, and insert a provision for a 
report from the committee on nominations, previous to the 
ballot for officers. 

Sec. 3 and 4. Repeal, and make the second section em- 
brace their provisions. 

Sec. 5. To be designated the third, and the following pa- 
ragraph to be added; — " two-thirds of the Fellows present 
concurring in the nominations. 



296 REPORT OF COMMITTEE ON CHARTER. 

CHAPTER VI. 

Title to he changed to "Ethics"; and the committee re- 
commend ihe adoption of the whole code agreed upon by 
the American Medical Association, with such alterations in 
chapter on consultations, as will make it embrace the regu- 
lations of the existing by-laws of this society on that sub- 
ject. 

CHAPTER VII. 

Sec. 1. Erase all that follows the word "appointed," on 
the forty-eighth page of printed by-laws, to the words 
"shall have power" &c, and insert the word "who" before 
^shall." 

Sec. 2. Erase from the word "liberty" to the words "to 
attend?' and substitute the words "this state" for " his 
general district." 

Sec. 5. Amend the second item of qualification, by in- 
serting after the words " certificate that" the following ; — 
'-he has acquired a good English education, a knowledge 
of Natural Philosophy ', Natural History, and Botany, 
the elementary mathematical sciences including Geometry 
and Algebra, and such an acquaintance at least of both the 
Latin and Greek languages, as will enable him to appre- 
ciate the technical language of medicine, and read and write 
prescriptions, and that" 

Sec. 4. Repeal. 

Sec. 6. To be designated the fourth. Insert after the 
words " Physic and midwifery," the following ; — they may 
also, if they deem it expedient, examine the applicant or 
applicants on the branches of general science and learning 
specified in the foregoing section. Amend the form of cer- 
tificate of examination, by erasing " district," and 
inserting "the District Medical Society, for the County 

of 

Amend the final paragraph of this section, by inserting 

after the words "every candidate" the words following, viz: 

— "not being a graduate of sonic respectable Medical Col- 



EIGHTY FOURTH ANNUAL MEETING. 297 

lege or University recognized by this Society," and after 
the words "presiding censor" the following ; — "but if the 
candidate shall exhibit a diploma certifying to his gradu- 
ation at any such medical College or University, then he 
shall be required to pay the sum of $5.00 which shall be en- 
dorsed on the certificate as before specified." 

Sec. 8. Erase from the word "State" to "but" and sub- 
stitute the word "and" for "but." 

CHAPTER VIII. 

Order 8th. Amend so as to make the table of fees sub- 
ject to such alterations as each district society may deem ex- 
pedient for its own locality. 

Order 11M. Erase the words "two-thirds" and "shall," 
and insert "any part" and "may." 



MINUTES OF THE EIGHTY FOURTH ANNUAL MEETING. 

The eighty-fourth annual meeting of the society was held 
in the chapel of Rutgers College, New Brunswick, May 14, 
1850. 

In the absence of Doctor Fithian, President, Dr. Marsh 
first vice President called the Society to order. 

OFFICERS. 

J. Fithian, President. 

E. J. Marsh, first Vice President. 

J. H. Phillips, second Vice President. 

0. H. Taylor, third Vice President. 

A. B. Dayton, Corresponding Secretary. 

W. Pierson, Recording Secretary. 

J. S. English, Treasurer. 

J. B. Coleman, J. J. Dunn, and J. L. Taylor, 

Standing Committee. 

FELLOWS PRESENT. 

J. T. B. Skillman, Z. Read, G. R. Chetwood, W. McKis- 

sack, J. W. Craig, J. B. Munn, S. H. Pennington, F. R. 

Smith, J. G. Goble, A. Skillman, and R. Smith. 
38 



298 EIGHTT FOURTH ANNUAL MEETING. 

Delegates were present from the following Districts — viz : 
Passaic, Essex, Morris, Sussex, Warren, Somerset, Mon- 
mouth, Burlington, Mercer, Hunterdon, Camden, Glouces- 
ter, Salem and Cumberland. 

The certificates of delegates were read and accepted. 

The minutes of the preceding meeting were read and 
approved. 

A communication was received from the President, re- 
questing his absence to be excused, on account of the recent 
death of his wife. His address, however, was transmitted 
to the society through doctor T. J. Saunders, and at the re- 
quest of the society, read by him. The subject, " Hygienic 
treatment of Consumption and infantile teething, with 
remarks on bilious fevers, cholera morbus, diarrhoea, &c." — 
Whereupon the thanks of the Society were voted, and a 
copy requested for publication. 

The following were appointed committee on Treasurers' 
accounts — -Drs. Chetwood, Gauntt, and Elmer. 

On unfinished business — Drs. Parrish, Paul and Nichols. 

On motion, Dr. Green of United States Navy, and all 
other medical gentlemen not delegates, who were present, 
were invited to take seats. 

On motion the following was adopted — "Resolved, That 
a committee of one from each district represented, be ap- 
pointed for the purpose of nominating officers for the ensu- 
ing year. Also to report the names of suitable persons for 
censors, for the respective district societies: the members of 
said Committee to be appointed by the delegates from the 
local societies respectively. The following were appointed 
the committee. Drs. Burr, Nichols, Green, Burgess, Cook, 
Martin, Debow, Budd, Phillips, Woodruff, Saunders, Bate- 
man, Cook of Salem, and Lilly. 

A communication was received from Dr. L. A. Smith, an 
attending delegate at the American Medical Association 
then in session, stating his arrival, and the progress which 
the association had made in its proceedings. 



EIGHTY FOURTH ANNUAL MEETING. 299 

The committee on the supplement respecting the benevo- 
lent fund submitted a report, stating that such supplement 
had been obtained from the Legislature — which report was 
accepted, and subsequently, on motion of committee on un- 
finished business, referred back to the former committee. 

The committee on revision of charter and by-laws, sub- 
mitted a report by their chairman, Dr. Pennington, propos- 
ing several alterations in the charter and by-laws, which 
was read, discussed, amended, and on motion it was 

Resolved, That the several principles in relation to the 
charter amendments, recommended by the committee be 
adopted and referred back to the same committee, to correct 
phraseology where necessary, and with discretionary pow- 
er to apply to the Legislature for their sanction. Drs. Craig, 
Phillips and Coleman were added to the committee. 

The following bills were ordered to be paid — 
Joseph C. Potts, for advertising application to 

Legislature, $2,25 

Samuel P. Hull, for advertising, 2,00 

Lea and Blanchard, for 14 copies Transac- 
tions of A. M. A. for 1S49, 23,38 
J. S. English, travelling expenses for obtaining them, 2,29 
L. A. Smith's travelling expenses to American 

Medical Association. 50,00 

Newark Daily Advertiser, 28,00 

J. B. Munn's expenses, to Trenton, 9,20 

Stille's bill for entertainment of Society, 56,00 

On motion, Resolved, That the President be authorized 
to grant a diploma to Selah Gulick, in the place of one par- 
tially destroyed. 

On vote of the society, the degree of Doctor of Medicine 
was conferred upon the following gentleman — JohnBowne, 
of Hunterdon ; Nathan W. Condict, of Morris, and J. T. B. 
Skillman, of Middlesex. 

The committee on Treasurers' accounts, report that 
they have examined his accounts, and find in the Treasurers' 
hands the sum of $237,31 cents, and upon their recqinmen- 



300 EIGHTY FOURTH ANNUAL MEETING. 

dation, it was Resolved, That the usual distributions to the 
several district societies be dispensed with for this year. 

Upon the recommendation of the Fellows present, the fol- 
lowing gentlemen were elected honorary members of the 
society, viz : — Lewis C. Beck, M. D., professor of chemistry 
of Rutgers College, and John C. Torrey, M. D., professor of 
chemistry, Nassau Hall. 

The standing committee by their chairman, Dr. Coleman, 
submitted their annual report, which was accepted. 

On motion, Resolved, That in future the Recording Secre- 
tary be instructed to publish the several notices and proceed- 
ings of the society, in the New Jersey Medical Reporter, in- 
stead of the newspaper journals. 

The following preamble and resolutions submitted by Dr. 
0. H. Taylor, were adopted. 

Whereas, it is a manifest duty that organized medical bo- 
dies should exercise a proper influence, for the protection of 
the rights of such regular members of the profession, as are 
necessarily detached from the great body of their brethren ; 
and whereas, many of the medical officers included in the 
military organizations of the country, are placed in this con- 
dition ; and whereas, we have heard with regret that there 
is a disposition on the part of a portion of the naval service, 
to deprive medical men connected with that department, of 
the benefits arising from an assimilated rank conferred by a 
general order of a late secretary of the Navy — therefore, be it 

Resolved, That the " New Jersey State Medical Society," 
regards with much pleasure, the successful efforts of naval 
boards, in raising the standard of literary and medical 
knowledge, for admission to their ranks. 

Resolved, That the society is also much pleased to learn, 
that in their system of examinations, the diplomas of the 
sehools, (which are now but too easily obtained,) are wholly 
disregarded ; and that the moral character of the candidate, 
and his scientific and professional attainments, are his only 
passports, to the medical corps of the navy. 

Resolved, That this society cannot look with indifference 
on any attempt to depress or degrade a whole class of offi- 
cers belonging to a liberal profession, and so indispensable 
in the proper organization of the navy. 

Resolved, That as a well defined "assimilated rank" has 



EIGHTY FOURTH ANNUAL MEETING. 301 

been assigned to medical officers of the Army, by an act of 
Congress, dated Feb. 1 1th, 1847, this society cannot believe 
that an invidious distinction will be made between the me- 
dical departments of the public service; but that the nation- 
al legislature, will grant to surgeons and assistant surgeons, 
their just claims to a nominal rank, or to a social position 
as respectable among the other grades of the Navy, as the 
medical staff of the Army now enjoy by law, in relation to 
their brethren of the line in that service. 

Resolved, That a copy of these resolutions be forwarded 
to the secretary of the navy, through the chief of the 
medical department ; and also that a copy be forwarded, to 
the chairman of the naval committee in each house of Con- 
gress. 

Dr. Saunders submitted a report of committee on prelimi- 
nary education, which was referred to the committee on "re- 
vision of charter and by-laws. 

Resolved, That the thanks of the society be presented to 
Faculty and officers of Rutgers College, for the use of their 
Hall for the meeting of the society, and that the Treasurer 
be instructed to pay the janitor for his services. 

Resolved, That the semi-annual meeting be held at Eliza- 
bethtown. 

The committee on nominations — reported the following 

for officers and censors, who were duly elected — 

President — E. J. Marsh, Paterson, 
First Vice President — J. H. Phillips, 
Second Vice President — 0. H. Taylor, 
Third Vice President — W. Nichols, 
Cor. Secretary — A. B. Dayton, Elizabethtown Point. 
Recording Secretary — W. Pierson, Orange. 
Treasurer — J. S. English, Manalapan, 
Standing Committee — Q. Gibbon, Salem, Chairman ; T. 
J. Saunders and A. E. Budd. 

CENSORS. 

Passaic — E. J. Marsh, G. Terhune, L. Burr, A. W. Rod- 
gers. 

Essex — G. R. Chetwood, A. Coles, A. N. Dougherty, and 
S. Personett. 

Morris— J. C. Elmer, T. Kitchell, H. P. Green, and R. 
W. Stevenson. 

Sussex — F. Moran, J. R. Stuart, A. Linn, J. Titsworth. 



302 EIGHTF FOURTH ANNUAL MEETING. 

Warren — W. P. Clark, R. Byington, P. Brakeley, and J. 
Fitch. 

Somerset— J. W. Craig, A. F. Taylor, H. Vanderveer, 
and J. R. Ludlow. 

Monmouth — R. W. Cook, A. B. Dayton, C. C. Blauvelt, 
and W. L. Debow. 

Burlington — B. H. Stratton, Z. Read, H. H. Longstreet, 
J. Parrish, G. Haines, and A. E. Budd. 

Mercer — J. Paul, J. B. Coleman, G. R. Robbins, and J. H. 
Phillips. 

Hunterdon — S. Lilly, G. P. Rex, J. Blane,and A. S. Clark. 

Camden— J. S. Mulford, 0. H. Taylor, C. D. Hendry, and 
A. D. Woodruff. 

Gloucester — J. R. Sickler, J. F. Garrison, J. C. Weather- 
by, and R. M. Smallwood. 

Salem — C. Hannah, C. Swing, Q. Gibbon, and T. Yarrow. 

Cumberland — W. Elmer, G. Tomlinson, E. C. Bateman, 
and J. W. Ludlam. 

DELEGATES TO THE AMERICAN MEDICAL ASSOCIATION. 

G. R. Chetwood and J. S. Mulford. 
Alternates — S. H. Pennington and A. D. Woodruff, 
Society adjourned. 

May 14, 1S50. W. Pierson, Rec. Sec. 

The following licentiates have been received, and diplo- 
mas granted by the President, Dr. Fithian. 
John J. Jessup, Atlantic County, 
Sylvester Vandyke, Hunterdon " 
J. W. Snowden, Camden " 

Theodore R. Varick, Hudson " 
Wm. S. Challis, Burlington " 
James Paul, Mercer " 

James D. Dewitt, Warren " 

David B. Trimble, Burlington " 
Lorenzo Fisler, Camden " 

R. M. McLanahan, Hunterdon " 
E. A. Heintzleman, Burlington" 
John S. Stiger, Warren " 

S. Tyler Miller, Gloucester " 

Frederick R. Graham, " " 

Isaac A. Nichols, Essex " 

Alex. C. Taylor, " " 

Wm Taylor, " " 

Frederick A. Kerk, « « 

Redley Kent " « 



ORIGINAL COMMUNICATIONS, 



BURLINGTON, SEVENTH MONTH, (JULY), 1350. 
AUTOPSY REVEALING THE ABSENCE OF GALL BLADDER. 

BY D. B. TRIMBLE, M. D. 

Under the impression that whatever will tend to enlighten 
us, in relation to the often obscure symptoms of disease, is 
worthy a place in the records of medical science, however 
humble may be the effort. I send for insertion in the Re- 
porter, an account of a post-mortem examination of some 
interest. 

The subject of examination was a woman, aged fifty-five 
years, whom I was called upon to attend, on the sixth of 
January. 

I found her complaining of pain in the epigastric region, 
nausea, occasionally vomiting, slightly furred tongue, 
pyrosis, anorexia, and constipation. All these symptoms 
had been progressing for several months, though she was still 
able to attend to her household duties. Firm pressure on 
the epigastric region gave her pain, but not acute. Her 
pulse was frequent, though not full, or tense. As her dis- 
ease progressed, she twice, at considerable intervals, and for 
some hours, complained of pain in the shoulder ; her appe= 
tite became more and more depressed ; emaciation increased 
rapidly, ascites supervened, and death released her on the 
24th of June. 

From the symptoms, I considered it a case of chronic gas- 
troenteritis, approaching the stage of ulceration, and the 
treatment was in accordance with these views. The autop- 
sical examination, however, shewed that my diagnosis was 



304 dr. Trimble's case. 

partially wrong, but at the same time proved that no medi- 
cal efforts would have relieved her. 

On the evening of the 24th, accompanied by my friend, 
Dr. Gauntt, I proceeded to the investigation, and on open- 
ing the abdomen, found it filled with serous fluid, of a red- 
dish color, in quantity about one gallon. The colon, and 
the small intestines were lying exposed, and the only ap- 
pearance of an omentum, was a strip about an inch in width, 
attached to the stomach. We next examined the intestines, 
commencing at the rectum, which was filled with ash-color- 
ed fasces, and inflamed. The csecum, thoug hless inflamed 
than the other intestines, had bright red patches throughout 
its coats ; the colon, jejunum, and ileum showed strong evi- 
dences of inflammation, being of a dark mahogany colour, 
and the coats of the small intestines much thickened. The 
mesenteric glands were discolored, but not enlarged. The 
duodenum was much contracted in size, and, about that 
portion of it where the pancreatic duct, and the ductus cho- 
ledochus penetrates it, was adherent to the liver and pan- 
creas. The stomach presented no signs of disease. The 
liver was diminished in size, the stomach being uncovered 
by the left lobe; the right lobe was also smaller, and the 
portion attached to the pancreas together with that viscus, 
were of a cartilaginous character. No g all-bladder > or any 
vestige of one could be found, after the most careful investi- 
gation. Upon opening the cartilaginous portion of the liver, 
a gall-stone was found imbedded in the ductus choledochus, 
just at its entrance into the duodenum. It measured in its 
long circumference two and three-quarter inches ; in the 
small circumference two inches, and weighed one hundred 
and nine grains. It is of a dull red color with patches of a 
white crystaline coating. The uterus was healthy in ap- 
pearance, though filled with a semi-organized substance.— 
Between the insertions of the round ligament, and the fallo- 
pian tube of each side, was a tumour, on the left side about 
the size of a large pea, and of an osseous consistence; on 



dr. Trimble's case. 305 

the right as large as]a hazel-nut, and cartilaginous. They 
were so situated, that the slightest pressure on them would 
close the orifices of the fallopian tubes. She had been mar- 
ried twenty-five years, but had not conceived. Could these 
tumours, by their mechanical eifect, be the cause ? The ova- 
ria were healthy. 

She had suffered for some years with the usual symptoms 
of indigestion ; but had not, at any time, very acute pain in 
the right hypochondriac, or epigastric regions ; at least none 
that could cause a suspicion of the passage of a calculus of 
the ordinary size. 

From the absence of the gall-bladder, no cystic bile could 
have been secreted ; and from the situation of the stone, no 
bile could pass into the duodenum, thus seriously deranging 
digestion and nutrition, producing the inflammatory condi- 
tion of the intestines, resulting in death, and the cause of 
which, no art could remove. 

The questions arise, what became of the omentum and 
gall-bladder? — or was this one of those abnormal forma- 
tions mentioned by authors, where those organs are absent ? 
If there was originally no gall-bladder, how was the calcu- 
lus formed ? or did its size produce ulceration and rupture 
of the bladder, and its subsequent absorption ? These are 
interesting questions, but difficult of solution. 

Upon mentioning the foregoing case to a medical friend 
from Philadelphia, he informed me that he recently had a 
case of calculi in the gall-bladder and ducts, resulting in 
death in fifteen hours, in which there was no pain in the 
right hypochondrium; but intense pain in the left, extend- 
ing to the epigastrium. Two of the most eminent of the 
physicians of that city, saw her with him, and were not led 
by her symptoms to suspect her disease, though one of them 
suggested that such might be the cause. The post-mortem 
examination disclosed the gall-bladder filled with small cal- 
culi, one of which, not larger than a small pea, had closed 

the passage of the cystic duct. These cases show the obscu- 
39 



300 DR. CHALLXSS' CASE. 

rity of the diagnosis in biliary calculi, and should lead us to 
suspect their presence when efficient means are unavailably 
used to relieve affections of the stomach and bowels, when 
timely resorted to. 
Burlington, June, 1850. 



A RARE CASE. 

BY WILLIAM L. CHALLISS, M. D. 

On the 13th of May, 1850, I was called to visit Mrs. 

M , aged about thirty-five, and found her confined to 

her bed, and laboring under a severe cough, accompanied 
with profuse expectoration. Her countenance was pale and 
dejected, indicative of much distress. In the course of my 
investigation, she told me of a tumour, which was growing 
in her " private parts," and which was the source of much 
uneasiness to her. Upon further inquiry, I deemed it not es- 
sential to her present safety, that an examination of this 
should be entered into, and therefore told her, that we would 
first mend her health, then direct our attention to the tumour. 
I accordingly put her upon the use of ferri. precip. carb. in 
dose gr. x. three times a day, together with a demulcent and 
anodyne syrup in small doses repeated frequently ; while at 
the same time counter irritation was made with croton oil over 
the upper portion of the right lung, where upon percussion, 
some dullness was discovered. The following day I found her 
much more composed ; and the cough somewhat abated in 
violence. The same treatment was continued, and on the 
fifth day she was enabled to occupy her accustomed seat at 
table with her family. A cold infusion of Wild Cherry Bark 
was now added as her common drink, and at the end of three 
weeks, she was fully able to resume her household duties. Her 
appetite was good, and the cough very slight, the expecto- 
ration having changed from the thick purulent, greenish co- 



DB. CHALLISs' CASE. 307 

lored matter, which sank in water, to a thin frothy mucus. 
During the whole of this time, the precipitated carbonate of 
iron was continued, and its beneficial effects were evinced 
in giving volume to the pulse, and vigor to the whole consti- 
tution. 

Her mind being still much troubled about the tumour, I 
commenced at this time an examination of it. I found it 
pending from the arch of the pubis — a corrugated, roundish 
tumour. With some difficulty I passed the finger into the 
vagina, and made careful and continued exploration both in 
the recumbent and erect posture, for the os tincae ; but none 
could be found. The vagina was perfect, and the globe of 
the womb could be distinctly felt high up. Being at some 
loss how to solve the discrepancy satisfactorily, with the free 
consent of the patient, I laid bare the parts ; and to my as- 
tonishment, found that this tumour was a perfect os uteri — 
firmly adherent to the pubis, immediately behind the orifice 
of the urethra. It is preternaturally large, and almost fills 
the entrance to the vagina. It is doubtless a mal-formation, 
which accounts for the rarity of her pregnancies. She 
has one child fifteen years old, and is now pregnant a second 
time — five months. What may be the result at the time of 
her confinement, I will leave for the reader to surmise. 

Moorestown } June, 1850. 



Note — We would suggest the enquiry to Dr. Challiss, whether his pa» 
tient had the curious mal-formatiou which he describes, before her first 
pregnancy 1 and if so, what was the character of her labor? We hope ia 
due season, to be informed of the history of her second accouchment.*=£d* 



EDITORIAL. 



NEW JERSEY MEDICAL REPORTER. 

BURLINGTON, SEVENTH MONTH, (JULY,) 1850. 

EDITORIAL. 



CLINICAL RECORDS. 

As by the wise regulations of the New Jersey Medical 
society, the standing committee is required to give an annu- 
al summary of the diseases, prevalent in the state: it has oc- 
curred to us that this object might be greatly promoted if 
each individual member would preserve a brief record of 
cases, that come under his notice, with the age, sex, and 
other circumstances of importance and interest, from which 
an exact medical history of his own district, might be 
annually presented through the reporters to the commit- 
tee. We would respectfully recommend this plan to our 
brethren, as easy of adoption, and highly interesting and 
valuable, even as a subject for personal reference. We 
have tried it for some time past, and find it an easy matter 
at the close of each day, to devote a few minutes to noting 
in the record book, the age, sex, disease, time when treat- 
ment was commenced, and the result of each case ; and are 
satisfied that a great amount of information may in this way 
be accumulated, with but little expenditure of labor or trou- 
ble. Having been so well satisfied ourselves, of the practi- 
cability and usefulness of the plan, we will be excused for 
urging its adoption upon our friends. 



EDITORIAL. 309 

OUR THIRD VOLUME. 
The third volume of this Journal is completed with the 
present number. In reviewing its history, we feel called 
upon to express our gratification with the manner in which 
so many of our medical brethren, have aided to sustain the 
work, both by their prompt responses to the claims of the 
publisher, and by the character of the communications, they 
have contributed to its pages. We regret very much, how- 
ever, that the publisher has recently felt himself required to 
issue a call for a prompt remittance of the amount of sub- 
scription, especially to subscribers who are certainly to be re- 
lied on : and while we know that there are many delinquents, 
we feel sure that he has not been happy in selecting those, 
who are always true to their duty, but who, in the press of 
professional engagements, may have overlooked the proper 
time for payment. It was not certainly intended by him to 
offend a single individual, but in his solicitude to make the 
Reporter do its share, toward supplying the claims of the 
workmen in his office, he has availed himself of the publish- 
ers license to dun, when he was most in need. 



TO CORRESPONDENTS. 
We acknowledge the receipt of several communications, 
which are crowded out of the present number, but will ap- 
pear in our next. 

1. A communication from Dr. Condict, on the use of Cod 
Liver Oil, &c. 

2. Cases of Hydrophobia, by Francis Moran, M. D. 

3. Essay on Periodic or Recurring Colics, by Joseph 
Garrison, M. D. 



NEW MEDICAL PUBLICATIONS. 

The New York Medical Gazette and Journal of Health, 

is a new weekly, issued from the office of S. S. and W. 

Wood, New York, at two dollars per annum, and under the 

editorial charge of D. Meredith Reese, M. D. It contains 



310 EDITORIAL. 

twelve pages of reading matter. The first number promises 
well ; we wish it success. 

The British American Medical and Physical Journal, ed- 
ited byArchibald Hall, M. D., of Montreal, Canada, comes 
to us in a much more convenient size and form, than under 
the old series. It contains 48 pages, and has, we think, a 
much better dress than when we first knew it. 

New Medical College. — The New York Medical College 
was chartered by the legislature of the State last winter, and 
is expected to go into operation in the ensuing fall. The 
chair of theory and practice has been filled by Horace Green, 
M. D.; of Chemistry, by R. Ogden Doremus ; of Surgery, by 
A. L. Cox, M. D., and applications for the other chairs will 
be received by John S. C. Abbot, No. 43, Lafayette Place, 
New York. 

University of Pennsylvania. — Some important changes 
have taken place in this time honored institution, consequent 
on the resignation of Dr. Chapman, who for so many years 
filled the chair of Practice with such distinguished ability. — 
Dr. Wood has been transferred from the chair of Materia 
Medica to that of Theory and Practice, and the vacancy oc- 
casioned by this transfer has been filled by Dr. Joseph Car- 
son, late of the College of Pharmacy. No one can doubt the 
ability of each to fill the respective places to which they 
have been assigned. Dr. Wood has gone to Europe on bu- 
siness connected with his recent appointment. 



Obituary — Died, in Philadelphia, Dr. Robert Egglesfield 
Griffith, in the 53d year of his age. — In London, Dr. Win. 
Prout, author of a work on the Stomach and Renal Diseases, 
and of one of the Bridgwater treatises. These, and other 
works of that distinguished author will long survive him. 
In Paris, at the advanced age of 83 years, M„ Capuron, a 
distinguished accoucheur, and teacher of Midwifery.— In 
Paris, March 4th, in the seventieth year of his age M. Mar- 
jolin, a distinguished Surgeon of that city.— In Paris, on the 
9th of May, M. Guy Lussac, the distinguished chemist and 
aeronaut. 



ECLECTIC DEPARTMENT. 



Abstract of the Minutes of the Third Meeting of the Ame- 
rican Medical Association, held in the City of Cincin- 
nati, May, 1850. 

The Association assembled in College Hall, May 17, 1S50, 
at 10$ o'clock, A. M., the President, Dr. J. C. Warren, in 
the chair. 

The committee of arrangements reported a list of dele- 
gates who had registered their names. 

The session was then opened by an address from the Pre- 
sident. 

On motion of Dr. Warren the constitution was read. 

Drs. Drake, Rives, Lawson, Dodge, Strader, and Richards, 
appointed last year on the committee of arrangements, but 
who were not members of the Association, and Dr. C. C. 
Caldwell were elected permanent members. 

On motion of Dr. Watson, a committee to nominate offi- 
cers for the present year was appointed, consisting of one 
delegate from each State represented, to be selected by the 
delegations from the respective States. The following were 
constituted that committee : Nathan Sanborn, New Hamp- 
shire ; Ezekiel Fowler, R. Island ; Worthington Hooker, 
Conn.; Calvin Jewett, Vermont ; Edward Reynolds, Massa- 
chusetts; T. W. Blatchford, New York; Enoch Fithian, 
New Jersey ; Caspar Morris, Pennsylvania ; James Couper, 
Delaware ; S. P. Smith, Maryland ; G. Lane Corbin, Vir- 
ginia ; Walter A. Norwood, North Carolina; Henry R. Frost, 
South Carolina; Paul F. Eve, Georgia; William B. John- 
ston, Alabama ; Bennett Dowler, Louisiana ; N. L. Thomas, 
Tennessee ; C. Q. Blackburn, Ky.; G. W. Boerstler, Ohio ; 
A. B. Palmer, Michigan ; H. G. Sexton, Indiana ; John 
Evans, Illinois ; W. M. McPheeters, Missouri ; S. G. Ar- 
mor, Iowa ; John Parker, Wisconsin. 

The committee of arrangements reported the names of 
persons recommended by various delegates for membership 
by invitation. 

On motion of Dr. White, of New York, the subject was 
referred to a special committee of five, to report the names 
of those who should be elected, and the following were ap- 



312 TRANS. AMERICAN MEDICAL ASSOCIATION. 

pointed the committee : Drs. Ware, of Massachusetts ; John- 
ston, of Missouri ; Dowler, of Louisiana ; Parrish, of Penn- 
sylvania ; Flint of New York. 

A letter was read from the secretary of the Smithsonian 
Institute, relative to the registration of diseases, &c, through- 
out the United States, and oiFering in behalf of the Smithso- 
nian Institute a room in its building for the meeting of the 
Association. 

On motion, that part of the letter respecting registration 
was referred to the committee on hygiene, and that in refer- 
ence to the room for the meeting of the Association to the 
committee on nominations. 

The Secretary asked and obtained leave to present the re^- 
port of the committee on publication, and the annual state- 
ment of the treasurer, which was read, referred to the com- 
mittee on publication, and the following resolutions append- 
ed to the report were adopted : — 

1. Resolved, That the annual assessment for the present 
year shall be three dollars. 

2. Resolved, That those delegates who pay the assessment 
shall be entitled to one copy of the Transactions for the pre- 
sent year, and that the payment of two dollars, in addition, 
shall entitle them to three copies of the same. 

3. Resolved, That permanent members shall be entitled to 
one copy of the Transactions for the present year, on the 
payment of two dollars ; and three copies, on the payment 
of five dollars. 

4. Resolved, That societies which are represented at this 
meeting, shall be entitled to copies, for their members at the 
same rates at which they are furnished to delegates, viz., 
three copies for five dollars. 

5. Resolved, That the permanent members, unless present 
at the meeting as delegates, shall not be subject to any as- 
sessment. 

6. Resolved, That any delegate who is in arrears for an 
annual assessment, shall not be considered as a permanent 
member. 

7. Resolved, That the several committees be requested to 
bring their reports fairly and legibly transcribed, and that 
they be required to hand their reports to the secretaries as 

soon as they are read. 

The report of the committee on hygiene was presented, 
and after a portion had been read, it was referred to the 
committee on publication. 



TRANS : AMERICAN MEDICAL ASSOCIATION, 313 

The committee on nominations reported the following as officers for the 
present year. 

President. — R. D. Mussey, Ohio. 

Vice President.— S B. Johnson, Missouri ; A. Lopez, Alabama; Daniel 
Brainard, Illinois; G. W. Norris, Pennsylvania. 

Secretaries.— Alfred Stille, Pennsylvania; H. W. De Saussure, South 
Carolina. 

Treasurer. — Isaac Hays, Pennsylvania. 

After some discussion the report was accepted. 

The President announced the report of the committee on education as 
the order of business of the day. 

Dr. Blatchford, of New York, presented the report of the committee on 
education, which he requested might be read by the Secretary, as the 
chairman of the committee was absent. The Secretary read the report. 

Dr. Blatchford offered the following preamble and resolutions, prefac- 
ing them with remarks, that although a member of the committee he had 
never seen the report until late on the preceding evening, and that he dis- 
sented altogether from the opinions it expressed. 

Whereas, This Association has learnt through its several committees, ap- 
pointed from year to year to examine into the state of medical education 
in our country, that many of the Medical Colleges, invested by law with 
the power of granting degrees, still continue a system of instruction which 
we cannot but regard as defective, both in the time allotted to the delivery 
of lectures, in the attention paid to practical anatomy, in the facilities af- 
forded for clinical instruction, and in the low standard of the requirements 
for a degree ; therefore, 

Resolved, That this Association reiterates its former recommendations 
upon these points, and would urge upon the Medical Colleges to continue 
their efforts to elevate the standard of medical education, by adopting such 
changes in their courses of instruction as shall satisfy the just and reason- 
able desires of the profession. 

Resolved, That the thanks of the American Medical Association are due 
to the Faculties of the University of Pennsylva7iia and of the College of Phy- 
sicians and Surgeons of Netv York, and all other institutions which may have 
conformed to our recommendations, for their prompt response to the re= 
commendations of the Association for the improvement of medical edu- 
cation. 

Dr. Roberts, of Maryland, also a member of the committee, stated that 
he had never seen the report until the preceding evening, and did not en- 
tirely approve of it. 

Dr. Stille wished to correct a statement made in the report, "that none 
of the Colleges of Pharmacy in the Atlantic cities seem to be in active op- 
eration. Dr. Stille called attention to the fact that the Colleges of Phar- 
macy of New York and Philadelphia were in active operation, and had 
shown their activity, among other ways, by taking an efficient part in pro- 
curing the passage of the law to prevent the importation of spurious and 
adulterated drugs. 

Dr. Isaac Wood, of New York, also desired to say, that the College of 
Parmacy of New York was in active and efficient operation. 

Dr. Parrish, of Pennsylvania, after having expressed his dissent at 
length from the doctrines of the report, moved that it take the usual course, 
and be referred to the committee on publication. 

Dr. Annan, of Kentucky, moved to amend by referring the report and 
the resolutions of Dr. Blatchford to a select committee, of which Dr. Par- 
rish should be chairman. 

After much discussion, and the offering and withdrawal of several reso- 
lutions, 

40 



314 TRANS: AMERICAN MEDICAL ASSOCIATION, 

Dr. Still6 offered the following resolutions as an amendment, which were 
adopted: — 

Resolved, That the report of the chairman of the committee on medical 
education be recommitted for correction as to matters of fact, and then 
banded to the committee of publication. 

Resolved, That the resolutions of Dr. Blatchford be made the special or- 
der for the meeting this afiernoon. 

On motion of Dr. Knight, of Connecticut, it was 

Resolved, That the committee appointed to nominate the officers of the 
the Association be continued, and that they be directed to nominate the se= 
veral standing committees of the Association for the ensuing year, and 
also to designate a place for the next meeting of the Association. 

Dr. Reyburn, of Missouri, in behalf of the Medical Society of the State 
of Missouri, tendered an invitation from said Society, to the National Me- 
dical Association to meet in St. Louis after the next annual meeting. 

The Association then adjourned to 3£ P. M. 

AFTEHNOON SESSION. 

Dr. Johnson, Vice President, in the chair. 

The discussion of Dr. Blatchford's resolutions was resumed, and 

Dr. Miller, of Kentucky, moved to amend the first by inserting after the 
word " efforts"—," and the lay members of the profession who take office- 
pupils to begin their efforts" — which was accepted by Dr. Blatchford. 

Before coming to a vote, the Association adjourned to 9 A. M. of Thurs- 
day. 

MAY 9th — MORNING SESSION. 

Dr. Johnson, Vice-President in the chair. 

After reading the minutes, and the transaction of some unimportant bu- 
siness, the President announced the resolutions of Dr. Blatchford as 
amended by Dr. Miller, of Kentucky, as the first business in order. 

Dr. Eve, of Georgia, moved that the resolutions be indefinitely postponed, 
which was not adopted. 

After much discussion and conversation, the previous question was 
moved by Dr. Edwards, of Ohio, and carried. 

A motion for a reconsideration having been made, was carried ; and the 
resolutions being again open for discussion, it was moved by Dr. J. R. 
Wood, of New York, that the Association go into committee of the whole, 
with Dr. Knight, of Connecticut, in the chair. 

This resolution having been adopted, Dr. Knight look the chair, and the 
Association went into committee of the whole. 

The committee rose to report, when, on motion of Dr. Lopez, the rules 
were suspended, in order to enable him to make an explanation and read 
a protest on behalf of the delegates of the State of Alabama, against cer- 
tain statements made in the report of the committee on education, in 1849, 
and published in the volume of Transactions of that year ; the protest con- 
cluding with the following preamble and resolution : — 

Whereas, The third section of the report on medical education, entitled 
" legal requirements exacted by medical practitioners in the several states 
of the Union," being discordant with the laws of the State of Alabama, 
now existing, and in force from 1823, unrepealed, and more especially at 
variance with a strict sense of justice and respect to the medical faculty of 
that state in their professional relations and public standing — 

Resolved, That the foregoing protest be entered upon the minutes of this 
present meeting, and published with its proceedings. 

On motion of Dr. Coxe, of Ohio, the protest was accepted, and referred 
So the committee on publication. 

Dr. Lopez, Vice-President, then took the chair. 



TRANS: AMERICAN MEDICAL ASSOCIATION. 315 

The chairman of the committee of the whole reported that they had had 
under consideration the preamble and resolutions of Dr. Blatchford, of New 
York, and certain other resolutions, herewith submitted, proposed by Drs. 
Lawson and Drake, of Ohio, Dr. Gross, of Kentucky, and Dr. Theobald, of 
Maryland, which were recommended by resolution of Dr. Flint, of New 
York, to be referred to the standing committee for 1851 ; and that they af- 
terwards adopted the accompanying resolution of Dr. Casper Morris, of 
Pennsylvania, offered as a substitute for the above. 

On motion, the report of the committee was adopted. 

Amendment offered by Dr. Lawson, of Ohio : — 

Resolved, That all the Medical Colleges be advised to require of their stu- 
dents to exhibit evidence of a good English education prior to graduation. 

Resolved, That Medical Colleges be advised to extend their lecture terms 
to at least five months. 

Resolved, That Medical Colleges be most earnestly requested to elevate 
the standard for graduation ; and that no candidate be permitted to receive 
a degree who does not evince a thorough knowledge of the elements of 
medical science. 

Resolved, That those schools which fail to comply with these resolutions, 
be refused a representation in this association. 

Amendment offered by Dr. Drake : — 

Resolved, That the medical schools of the United States should require 
pupils to remain till the end of the session, whatever may be its length, 
except when permission may be given to depart. 

Amendment offered by Dr. Theobald, of Maryland : 

Resolved, That those medical schools in the United States, which have 
laws requiring a student to be twenty-one years of age, and to study me- 
dicine three years before he is eligible to the degree of M. D., be requested 
to enforce said laws ; and that those which have no such laws enact them. 

Amendment offered by Dr. Gross, of Kentucky: — 

Resolved, That the resolution be so far amended as to strike out the 
words, "of the University of Pennsylvahia, and the College of Physicians 
and Surgeons of New York." 

Resolution offered by Dr. Morris, of Pa., as a substitute, adopted in com- 
mittee of the whole, reported to the Association, and passed. 

Resolved, That the recommendations of this Association at its former 
meetings, in regard to medical education, be reaffirmed, and that private 
preceptors be still urged to receive into their offices only those duly qual- 
ified by previous education to engage in the study of medicine. 

On motion of Dr. Flint, the report of the committee on practical medi- 
cine was made the special order and business for the afternoon session. 

On motion, the Association adjourned to meet at 4 P. M. 

AFTERNOON SESSION. 

Dr. Lopez, Vice-President, in the chair. 

A communication from Dr. Fenner, of Louisiana, was received, accom- 
panied by a portion of a work, now in course of publication, relating to the 
medical topography and diseases of the south-west, and upon which sub- 
ject he asked the co-operation of the Association. 

On motion of Dr. Watson of New York, it was 

Resolved, That Dr. Fenner's projected'annual publication of the diseases 
and medical statistics of the southern portion of the United States, meets 
with the cordial approbation of the American Medical Association, and is 
worthy of the active support and co-operation of the profession. 

Dr. 1. K. Mitchell, of Philadelphia, presented and read the report of the 
standing committeee on Practical Medicine, which ^as on motion received 
and referred to the committee on publication. 



316 TRANS.* AMERICAN MEDICAL ASSOCIATION. 

The following list of nominations was presented by the nominating 
committee. 

Medical Sciences.- — Dr. Bennett Dowler, of New Orleans, Chairman. Drs. 
E. D. Fenner, New Orleans; G. L. Upsher, Norfolk, Virginia; W. B. 
Johnston, Marion, Alabama; F. G. Smith, Philadelphia ; E. Carr, Canan- 
dasua, New York ; G. W. Meers, Indianapolis, Indiana. 

Practical Medicine. — Dr. Austin Flint, Buffalo, New York, Chairman. — 
Drs. H. M. Conger, Buffalo, New York ; R. H. Davis, Baltimore, Mary- 
land; W. A. Norwood, Hillsborough, North Carolina; G. L. Corbin, 
Halfway House, York County, Virginia; J. McNaughton, Albany, New 
York ; R. Haymond, Brookville Indiana. 

Surgery. — Dr. Paul F. Eve, Augusta, Georgia, Chairman. Drs. J. N. 
Simmons, Griffin, Georgia; John Watson, New York; H. H. McGuire, 
Winchester, Virginia; S. D. Gross, Louisville, Kentucky; C. A. Pope, 
Sen., St. Louis, Missouri ; A. B. Palmer, Tecumseh, Michigan. 

Obstetrics. — Dr. D. H. Storer, Boston, Chairman. Drs. E. Reynolds, Bos- 
ton ; H.Miller, Louisville, Kentucky ; S.Thompson, Albion, Illinois ; T. 
M. Smith, Brandywine, Delaware; R. Parker, Kenoska, Wisconsin ; A. J. 
Mullen, Napoleon, Indiana. 

Medical Education. — Dr. Worthington Hooker, Norwich, Connecticut, 
Chairman. Drs. T. W. Blatchford, Troy, New York; J. B. S. Jackson, 
Boston ; E. W. Theobald, Baltimore ; J. R. Wood, New York; N. S. Da- 
vis, Chicago, Illinois ; C. J. Blackburn, Covington, Kentucky. 

Medical Literature. — Dr. Thomas Reyburn, St. Louis, Chairman. Drs. 
W. M. McPheeters, St. Louis ; L. M. Lawson, Cincinnati ; S. Annan, Lex- 
ington, Kentucky ; J. Cooper, Newcastle, Delaware ; G. Tyler, Washing- 
ton, D. C; N. L. Thomas, Clarksville Tennessee. 

Committee on Publication. — Dr. Isaac Hays, Philadelphia, Chairman. Drs. 
A. Stille, D. F. Condie, Philadelphia ; H. W T . DeSaussure, Charleston ; J. 
R. W. Dunbar, Baltimore; I. Parrish, Philadelphia; N. Sanborn, Henni- 
ker, New Hampshire. 

Committee of Arrangements. — Dr. H. R. Frost, Charleston, Chairman. — 
P. C. Gaillard, H. W. DeSaussure, W. T. Wragg. J. P. Jervey, R. Lebby , 
D. J. Cain, Charleston. 

The Committee also recommended that the next meeting of the Associ- 
ation be held at Charleston, South Carolina. 

On motion of Dr. Bowditch the report was adopted. 

Dr. Evans, of Chicago, presented a brief report from Dr. Prioleau, 
Chairman of the committee on obstetrics, which was read and referred to 
the committee of publication, to be published or not at their discretion. 

Dr. Evans also presented a paper, relating to a new instrument invented 
by him, called the " obstetrical extractor," and which he exhibited to the 
Association, describing upon the mannikin the mode of manipulating it. 
The paper was referred to the same committee and with like conditions, 
as the last. 

Dr. Drake, as Chairman of the committee of arrangements, introduced 
a paper bv Dr. N. S. Davis, upon the question " Has the cerebellum any 
special connection with the sexual propensity, or function of generation 1" 
It was read by its author and referred to the committee on publication. 

The Association then adjourned to Friday at 9 A. M. 

may lOlh. 

Dr. Johnston, Vice President, in the Chair. 

The minutes of the previous meeting were read and approved. 

Dr. Parsons of Rhode Island, Chairman of the Committee on Medical 
Sciences, presented the report of the committee, which was received, and 
referred to the committee on publication. 



TRANS : AMERICAN MEDICAL ASSOCIATION. 317 

Dr. Huston, chairman of the committee on spurious and adulterated 
drugs, read his report, concluding with the following resolutions: — 

Resolved, That the various state and local medical societies, be requested 
to annually appoint boards of examiners, whose duty it shall be to procure 
specimens of drugs from the stores within their limits, for examination, 
and report upon the same to their respective societies, at least once in 
every year. 

Resolved, That the respectable druggists and apothecaries, throughout 
the United States, be requested to take active measures for suppressing 
fabrication and sale of inferior and adulterated drugs, and that it is re- 
spectfully suggested lo them, whenever practicable, to form themselves 
into societies or colleges for the promotion of pharmaceutical knowledge, 
and general improvement in their profession. 

Resolved, That a committee be appointed, consisting of one member from 
each state here represented, whose duly it shall be to collect information 
in regard to spurious and adulterated drugs, and report the same at the 
next meeting of the Association. 

Dr. Mussey, chairman of the committee on surgery, presented and read 
lhe_ report of the commitiee, which on motion was received and referred to 
the committee on publication. 

The following resolutions offered by Dr. Stille, were adopted. 

Resolved, That Dr. Caldwell be requested to prepare a report, to be pre- 
sented at the next meeting, showing how far, in his judgment, the sciences 
of phrenology and mesmerism are founded in truth, and to what extent a 
knowledge of them may be rendered subservient to the treatment and cure 
of diseases. 

Resolved, That Dr. Caldwell be requested to take into consideration the 
subject of vital organic chemistry, and report to the next meeting whether, 
in his judgment, it can be justly called a branch of science, and if so, how 
far a knowledge of it can be rendered available to the welfare of man. 

The committee on nominations reported the following names for com- 
mittees. 

Committee on Indigenous Medical Botany and Materia. Medica, — Dr. A. Clapp, 
New Albany, Indiana ; Drs. J. M. Bigelow, Lancaster, Ohio; G. Engle- 
rnan, Missouri ; H. R. Frost, Charleston, South Carolina; J. Carson, Phi- 
ladelphia, Pennsylvania; N. B. Ives, New Haven, Connecticut; U. Par- 
sons, Providence, Rhode Island. 

Commitiee on Hygiene. — Dr. .lames Moultrie, Charleston, South Carolina ; 
Drs. P. C. Gaillard do.; W. DeSaussure, do.; D. Drake, Cincinnati, Ohio ; 
L. H. Anderson, Sumptersville, Alabama; G. Emerson, Philadelphia Penn- 
sylvania; J. Parrish, Burlington, ^iew Jersey. 

On motion, the report was accepted, and the nominations confirmed. 

On motion, the report of the committee on medical literature was made 
the special order for the afternoon session. 

On motion of Dr. Yardley, it was 

Resolved, That the committee on hygiene be requested to report on the 
best plan of warming and ventilating public and private buildings. 

Dr. Blatchford of New York, offered the following resolution : — 

Resolved, That a special committee on pharmacy, and the adulteration of 
drugs, shall be appointed by the President, consisting of seven members, 
of whom Dr. T. 0. Edwards, of Ohio, shall be chairman, to report at our 
next annual meeting, and that the special committee on Forensic Medicine 
appointed last year under Dr. Stevens' resolution be reappointed, and that 
it be optional with Dr. Stevens to continue as chairman, or to appoint a 
successor, which was adopted. The following committee on pharmacy 
and adulterated drugs were appointed. Dr. T. O. Edwards, Cincinnati, 
Chairman. Drs. T. W. Blatchford, Troy, New York; R. M. Huston, Phila- 



31 S TRANS: AMERICAN MEDICAL ASSOCIATION. 

delphia ; H. I. Bowditch, Boston ; E. W. Theobald, Baltimore ; H. R. Frost, 
Charleston ; J. B. Johnson, St. Louis. 

On motion of Dr. Morris, of Pennsylvania, it was 

Resolved, That it is with great satisfaction the members of this Associa- 
tion have observed the establishment of drug stores, in which, neither pa- 
tent medicine, nostrums, nor other articles, by which the artful and design- 
ing impose on the ignorant and credulous, are exposed for sale ; and that 
the Association recommends to its members to exert their influence in 
their respective spheres of action to encourage similar efforts in other 
places. 

Dr. Phelps, of New York, offered the following preamble and resolution, 
which were adopted. 

Whereas, The clerical profession often, though, perhaps, sometimes un- 
warily, yield their extensive influence in the community, in giving currency 
to quackery and quack medicines, therefore 

Resolved, That this subject be referred to the committee on hygiene, to 
consider, and report at the next annual meeting of the Association. 

Dr. W. Hooker, of Connecticut, offered the following resolutions : — 

Resolved, That the rule in relation to nostrums and secret medicines con- 
tained in our code of medical ethics, ought to be strictly observed by the 
medical profession, under all circumstances. 

Resolved, That when a physician claiming to be the inventor of a new 
medicine, and using the measures of the common quack "in effecting its 
sale, manages to escape censure and punishment, and to obtain even the 
countenance of a portion of the profession by revealing the composition 
of his medicine to such of his medical brethren as may desire it, he is 
guilty of a dishonorable evasion of the rule referred to, and should be so 
considered and treated by the whole profession. 

Dr. Lawson, of Ohio, moved to amend by the addition of the following 
resolution : 

Resolved, That this Association regards it as contrary to its system of 
ethics for Medical Journals to advertise nostrums, or secret remedies, al- 
though their composition may have been made known to the editor. 

The resolutions and the amendment were then adopted. 

The Association adjourned at 3| P. M. 

AFTERNOON SESSION* 

Dr, Johnson, Vice Pessident, in the chair. 

Dr. Miller, of Kentucky, moved a suspension of the rules, and offered 
the following preamble and resolution, which were adopted : — 

Whereas, Clinical instruction in medicine and surgery is now generally 
acknowledged to be essential to the proper qualification of students for the 
practice of these branches of our profession, and whereas, it must be ad- 
mitted that clinical instruction in midwifrey would be equally valuable, 
therefore, 

Resolved, That the committee on medical education be instructed to in- 
quire whether any practicable scheme can be devised to render instruc- 
tion in midwifrey more practical that it has hitherto been in the medical 
schools of the United States, and report at the next meeting of the Associ- 
ation. 

Dr. Stille, chairman, presented and read the report of the committee on 
medical literature, concluding with the following resolutions: — 

Resolved, That the Association regards the cultivation of medical litera- 
ture as essential to professional improvement, and as adapted to form one 
of the broadest lines of distinction between physicians and all pretenders 
to the name. 

Resolved, That in the opinion of this Association it is equally the duty 



TRANS: AMERICAN MEDICAL ASSOCIATION. 319 

and the interest of the profession to sustain its periodical literature, both 
by literary contributions and subscription. 

Resolved, That the standing committee on medical literature be instruct- 
ed to report to the Association at its next meeting what American medical 
work, published during the year of their service, in their judgment is the 
most valuable, and with the consent of the Association such work shall 
be formally proclaimed by the President. 

Resolved, That state and local societies are hereby recommended to of- 
fer pecuniary reward or other distinction for the best memoir founded 
upon original observation. 

Resolved, That medical colleges are hereby recommended to distinguish 
the best inaugural theses by a public announcement of its subject and the 
name of its author, and in such other manner as they may deem appro- 
priate. 

Resolved, That the sum of one hundred dollars, raised by voluntary 
contribution, be offered by this Association for the best experimental 
essay on a subject connected either with Physiology on medical chemistry, 
and that a committee of seven be appointed to carry out the objects of this 
resolution: said committee to receive the competing memoirs until the 
first day of March, 1851; the authors' names to be concealed from th'e 
committee ; and the name of the successful competitor alone to be an- 
nounced after the publication of the decision. 

On motion, the report was accepted and referred to the committee of 
publication, and the resolutions were considered seriatim and adopted. 

The following were appointed the committee to carry out the last reso- 
lution of the committee on medical literature, viz: — 

Dr. F. G. Smith, Philadelphia, chairman : Drs. A. Stille, Phildelphia ; R, 
Bridges, do.; W. L, Atlee, do.; F. Bache, do.; L. P. Yandell, Louisville ; J. 
Moultrie, Charleston. 

The report of the special committee, Drs. Horner, Condie and Hays, ap- 
pointed to consider the measures suggested in the report on medical litera- 
ture for 1849, was submitted. The following resolution, appended to the 
report, was read and adopted. 

Resolved, That in the opinion of this Association the only legitimate 
means within our reach for the encouragement and maintenance of a na- 
tional medical literature, is to increase the standard of preliminary and 
professional education required of those who would enter the medical 
profession; to promote the circulation among the members of the profes- 
sion of the medical journals of the day ; to encourage the establishment 
of district medical libraries; and to induce every practitioner to cultivate, 
with care, the fields of observation and research that are within his reach, 

On motion, the report was referred to the committee of publication. 

Dr. Gross, of Kentucky, offered the following preamble and resolutions, 
which were adopted : — 

Whereas, The interests'and the dignity of the medical profession of the 
United States, as well as a true spirit of patriotism and a love of indepen- 
dence, demand that we should use all proper and honorable means for the 
establishment of a national medical literature ; and whereas, we have hith- 
erto paid too blind and indiscriminate a deference and devotion to Euro- 
pean authorities, and not sufficiently patronized and protected our own : 
therefore, 

Resolved, That this Association earnestly and respectfully recommend 
to the medical profession generally, and to the various medical schools in 
particular, the employment of native works as text-books for their pupils, 
instead of the productions of foreign writers. 

Resolved, That the editing of English works by American physicians, 
has a tendency to repress native literary and scientific authorship, and 



520 trans: American medical association. 

ought therefore to be discouraged by all who have at heart the objects con- 
templated in this preamble. 

Resolved, That this Association will always hail with satisfaction, the re- 
print in their original and nnmutilatej form of any meritorious works that 
may emanate from the British press. 

On motion of Dr. Bowditch, of Massachusetts, it was 
Resolved, That the committee on medical education be requested to re- 
port at the next annual meeting of the Association, whether, in their opin- 
ion, any plan can be devised whereby medical students may receive a 
more thorough education in practical chemistry than they receive at pre- 
sent at any of the Medical Colleges of the Union. 

The Secretary presented the report of the committee on Indigenous Me- 
dical Botany ; a report on the vital statistics of New Orleans, by Dr. J. C. 
Simmonds; Biographical Notices of deceased Physicians, by Dr. Wil- 
liams, of Massachusetts, all o( which were referred to the committee on 
publication : and a catalogue of Indigenous Medical Botany, by Dr. Bige- 
low, of Ohio, which was referred to the committee on Botany. 

Dr. Flint, of New York, submitted the following resolution, which was 
adopted: — 

■Resolved, That the manuscript work of the late lamented Dr. Forry, be 
referred to the committee on publication, to be published in connection 
with the transactions of the Association, provided it be deemed advisable 
by the committee, and consistent with the pecuniary resources of the 
Association. 

Dr. W. L. Sutton, of Kentucky, nominated by Dr. Drake a permanent 
member, was unanimously received. 

On motion of Dr. Gross, of Kentucky, it was 

Resolved, That a committee be appointed, to report at the next annual 
meeting of this Association on the propriety of recommending to the Ame- 
rican people the importance of establishing schools of veterinary medicine 
and surgery, in which the diseases of the horse, ox, dog, and other domes- 
tic animals may be investigated, and thorough and sufficient courses of 
instruction delivered to such young men as may wish to qualify them- 
selves for the practice of the verterinary profession. 

The committee is composed of Drs. S. D. Gross, David W. Yandell, and 
L. Powell, of Louisville. 

Dr. M. Z. Kreider, of Ohio, presented a protest and resolutions against 
the vending of spurious and adulterated drugs, from the Fairfield county 
Medical Institute, which was read by the Secretary, and referred to a spe- 
cial committee, of which Dr. Edwards is chairman. 

The following resolution, submitted by Dr. Mead, of Illinois, was refer- 
red to the committee on medical education : 

Resolved, That the committee on medical education be instructed to in- 
quire into the expediency of recommending to the Colleges to abolish the 
rule which allows four years' practice to be received as an equivalent for 
attendance on one course of lectures, and to require all candidates for 
graduation to attend two full courses ; also, the expediency of adopting a 
uniform rate of lecture fees, varying in amount only between the Colleges 
of the North and those of the South. — Medical News and Library. 



V 

f HARVARD UNIVERSITY 

^ Library of the Medical School 




The Warren Library 

Dr. John Warren 
1753-1815 

Dr. John Collins Warren 

<§> 1778-1856 

/$ Dr. Jonathan Mason Warren 

Y 1811-1867 

A Dr. John Collins Warren 

X 1842-1927 

^ Dr. John Warren # 

* 1874-1928 # 











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